Obesity Surgery

, Volume 26, Issue 1, pp 45–53

The Effect of Weight Loss on Indigenous Australians with Diabetes: a study of Feasibility, Acceptability and Effectiveness of Laparoscopic Adjustable Gastric Banding

  • Paul E. O’Brien
  • Dawn E. DeWitt
  • Cheryl Laurie
  • Leah Brennan
  • John M. Wentworth
  • Margaret Anderson
  • Kerin O’Dea
  • Felicia Dean
  • Andrew Smith
  • David P. Dalton
Original Contributions

Abstract

Background/Objectives

Diabetes and obesity are common and serious health challenges for indigenous people worldwide. The feasibility of achieving substantial weight loss, leading to remission of diabetes, was evaluated in a regional indigenous Australian community.

Subjects/Methods

A prospective cohort study of 30 obese indigenous adults from the Rumbalara Aboriginal Co-operative in Central Victoria was performed. Inclusion criteria included aboriginality, BMI > 30 kg/m2 and diabetes diagnosed within the last 10 years. Weight loss was achieved using laparoscopic adjustable gastric banding (LAGB). Participants were treated in their community and followed for 2 years. Outcomes were compared with those of non-indigenous Australians from an earlier randomized controlled trial (RCT) using a similar protocol.

Results

30 participants (26 females, mean age 44.6 years; mean BMI 44.3) had LAGB at the regional hospital. Twenty-six participants completed diabetes assessment at 2 years follow-up. They showed diabetes remission (fasting blood glucose < 7.0 mmol/L and haemoglobin A1c (HbA1c) < 6.2 % while off all therapy except metformin) in 20 of the 26 and a mean weight loss (SD) of 26.0 (14) kilograms. Based on intention-to-treat, remission rate was 66 %. Quality of life improved. There was one early event and 12 late adverse events. The outcomes for weight loss and diabetes remission were not different from the LAGB group of the RCT.

Conclusions

For obese indigenous people with diabetes, a regionalized model of care centred on the LAGB is an effective approach to a serious health problem. The model proved feasible and acceptable to the indigenous people.

Trial Registration

Australian New Zealand Clinical Trials Registry (ACTRN 12609000319279).

Keywords

Type 2 diabetes Obesity Bariatric surgery Gastric banding LAGB Indigenous Aboriginal Remission of diabetes Weight loss 

Abbreviation

LAGB

Laparoscopic adjustable gastric band

SF-36

Medical Outcomes Trust 36-Item Health Survey

RAC

Rumbalara Aboriginal Co-operative

VACCHO

Victorian Aboriginal Community Controlled Health Organisation

CORE

Centre for Obesity Research and Education

SPSS

Statistical Package for the Social Sciences

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Paul E. O’Brien
    • 1
  • Dawn E. DeWitt
    • 2
    • 3
  • Cheryl Laurie
    • 1
  • Leah Brennan
    • 1
    • 5
  • John M. Wentworth
    • 1
  • Margaret Anderson
    • 1
  • Kerin O’Dea
    • 4
  • Felicia Dean
    • 3
  • Andrew Smith
    • 1
  • David P. Dalton
    • 2
  1. 1.Centre for Obesity Research and EducationMonash UniversityMelbourneAustralia
  2. 2.School of Rural HealthThe University of MelbourneSheppartonAustralia
  3. 3.Rumbalara Aboriginal Co-operative Pty. LtdMooropnaAustralia
  4. 4.School of Population HealthUniversity of South AustraliaAdelaideAustralia
  5. 5.School of PsychologyAustralian Catholic UniversityMelbourneAustralia

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