Is Weight Loss a Cure for Type 2 Diabetes?

It has been estimated that ∼10% of the U.S. population will be diagnosed with type 2 diabetes by the year 2010. Cardiovascular disease accounts for 75% of all related deaths in diabetic patients. While the use of HMG CoA reductase inhibitors has contributed to a marked reduction in mortality in cardiovascular deaths, the benefit in type 2 diabetes has been disappointing. Patients with type 2 diabetes have a sixfold increased risk of a first-time myocardial infarction compared with nondiabetic patients (1). Additionally, diabetic patients have twice the risk of myocardial infarction. As cardiovascular mortality is the leading single cause of death in the U.S. and because patients with type 2 diabetes have a three- to eightfold increased risk of death, new treatment strategies need to be considered for this disease and its prevention (1).

Dixon and O’Brien (2) describe the effects of laparoscopic adjustable gastric band surgery on the development of type 2 diabetes. All patients had severe obesity (BMI ≥35.0 kg/m²). One year after surgery, 64% patients had remission of diabetes. The prevalence of diabetes decreased from 10 to 5.6%. An additional 26% of patients with diabetes had an improvement in their control of diabetes. Gastric band surgery resulted in an average weight loss of 27 kg. HbA_1c was reduced from 7.8 to 6.2%. The 1.6% fall in HbA_1c was also associated with a 58-mg/dl …