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BMJ 2008; 336 doi: (Published 31 January 2008) Cite this as: BMJ 2008;336:242

Gastric banding could be a new treatment for type 2 diabetes

Obesity causes type 2 diabetes and weight loss relieves it. So researchers from Australia did a preliminary trial to evaluate laparoscopic gastric banding as a treatment for diabetes. It seemed to work. Obese adults treated surgically lost a fifth of their body weight in two years, by which time three quarters of them were in remission and no longer needed treatment (22/30). Controls who went on a diet and tried to take more exercise lost 1.7% of their body weight. Only four of 30 controls were in remission at the end of the trial. Both groups had the same optimal medical treatments and lifestyle advice. Participants treated surgically were five times more likely to be in remission (relative risk 5.5, 95% CI 2.2 to 14.0). Weight loss explained most of the difference between the groups. Three people needed revision banding. Two others had minor surgical complications.

An editorial describes the results as clear and striking (p 341). They are in line with the findings of large observational studies that also suggest a role for gastrointestinal surgery in people with diabetes caused by obesity. It is too early to generalise widely from these 60 Australians, however. They had relatively mild diabetes and body mass indices of no more than 40. They were also treated by one of the most experienced surgical teams in the world.

Low concentration of vitamin E associated with physical decline

Low serum concentrations of vitamin E have been linked to a faster physical decline in older adults. Researchers put a cohort of 698 Italian men and women over 65 through three physical tests to derive a functional score between 0 (worst) and 12 (best). They were retested three years later, when scores were a mean 1.1 points lower. Men and women with the lowest serum concentrations of …

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