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Study: Stomach banding beats drugs in curing diabetes

Rating

4 Star

Study: Stomach banding beats drugs in curing diabetes

Our Review Summary

This was an interesting story reporting on the diabetes improvement that may follow gastric banding surgery.  But the story erred in referring to ‘curing’ type II diabetes.  The evidence from the paper never mentions cure; it discusses remission, which is not the same thing as cure. It has different meaning for patients too. So we advise against using these words interchangeably. We don’t know if these patients will stay in remission for the rest of their lives. This is only a 2 year study.

An important message that should have been reiterated is that the impact of gastric banding surgery to effect diabetes is linked with weight loss.  While the surgery may better enable people to engage in lifestyle changes and lose weight, it is certainly not a magic bullet.  In the absence of dietary change, meaning reduction in caloric intake, this surgery does not appear to alter diabetes.  This is a key piece of information that needs to be included in the messages about the possible benefits of this procedure.  

Costs should have been discussed in this article, including out of pocket costs. Harms were not discussed.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story did not provide information about the costs associated with gastric banding or the intensive follow-up that the people in this study received.  It also failed to mention that this procedure is not always covered by medical insurance.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story informed readers that most of the people undergoing gastric banding saw resolution of their diabetes after one year if they lost sufficient weight.  However the story errs on the side of treatment mongering.  Using the word "cure" in the first paragraph is overly enthusiastic for this approach to diabetes. The study from which the story was developed discusses remission of diabetes which is not the same thing as a cure.  In addition, the study only followed patients for 2 years.  We don’t know whether the improvement in diabetes status will be longer lasting than this or whether the remission will slowly erode.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

There was no mention of the harms of treatment; two out the 30 patients who had gastric banding surgery had to have their bands removed (one due to something reported as ‘band intolerance’ which occurred early on; one who experienced persistent regurgitation after less than a year). While these complications were able to be resolved, for people considering this procedure, it would be of interest to know that it could be a potential problem and not a long term solution in as many as 1 in 15 individuals.

The story could also have mentioned the potential harms of gastric bypass, which are more significant than gastric banding. 

 

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story did provide some evidence about the percentage of individuals that experienced resolution of their diabetes following gastric banding. It mentioned that remission of diabetes occurred within a year and that weight loss appeared to be the factor that resulted in this benefit of treatment.  Towards the end of the story, it explained that the results reported followed a small number of patients and that they had had type II diabetes for a relatively short period of time. 

It failed, however, to mention that the results obtained in this study are better than that of other investigators and that the people in this study also engaged in a relatively intensive lifestyle intervention that may have better enabled their weight loss. 

Does the story commit disease-mongering?

Satisfactory

The story explained that 20 million Americans have type II diabetes and that it is currently the fifth leading cause of death in this country – appropriate context.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story included information from the research paper it was reporting on, an editorial in the journal that accompanied the paper, and two quotes from experts without overt links to the research.  In addition, the story included information about the source of funding for the study.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story did compare the effects on diabetes obtained with gastric banding with those seen with gastric bypass surgery; it also explained that there has not been a trial directly comparing the two procedures in terms of their ability to improve diabetic status.  It also included the information from the study that demonstrated the difficulty of weight loss in the absence of weight loss surgery.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The story did not clarify the availability of gastric banding in the United States.  It is a procedure that may not be performed by all surgeons or be available at all hospitals that offer weight loss surgery.

Does the story establish the true novelty of the approach?

Satisfactory

The story did not really comment on the novelty of gastric banding as a weight loss surgery.  From the context of the information it rightly made it appear as if there was some history of its use.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Does not appear to rely on a press release.

Total Score: 7 of 10 Satisfactory

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