Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

The Effect of Weight Loss on Indigenous Australians with Diabetes: A study of Feasibility, Acceptability and Compliance for Laparoscopic Adjustable Gastric Banding (#93)

John Wentworth 1 , Paul E O'Brien 2 , Kerin O'Dea
  1. Royal Melbourne Hospital, Monash Centre for Obesity Research and Education and Walter and Eliza Hall Institute, Melbourne, VIC, Australia
  2. Monash University Centre for Obesity Research and Education, Prahran, Australia

We performed a prospective cohort study of 30 obese Indigenous adults from the Rumbalara Aboriginal Cooperative in Central Victoria to determine the effectiveness of laparoscopic adjustable gastric band surgery for type 2 diabetes. Inclusion criteria included aboriginality, BMI > 30 kg/m2 and diabetes diagnosed within the last 10 years. Outcomes at two years were compared with the LAGB group of a randomized controlled trial of non-Indigenous Australians using a similar protocol.

Thirty participants (26 female, mean age 44.6 yr; mean BMI 44.3) had LAGB at a regional hospital with an overnight stay. There were no in-hospital complications but one serious early adverse event. 26 participants completed the 2 yr of follow up. They showed a mean weight loss (SD) of 26.0 (14)kg and diabetes remission (fasting blood glucose < 7.0 mmol/L and HbA1c < 6.2% while off all therapy except metformin) occurred in 20 of the 26. Based on intention-to-treat, remission rate was 66%.  Quality of life improved. There were 12 late adverse events mainly related to access port problems. The outcomes for weight loss and diabetes remission were not different from the LAGB group of the earlier RCT.

We conclude LAGB is an effective treatment for obese Indigenous people with diabetes. The model is feasible and it is acceptable to the Indigenous people