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Changes in glycaemic control, blood pressure and lipids 5 years following laparoscopic adjustable gastric banding combined with medical care in patients with type 2 diabetes: a longitudinal analysis
Author(s) -
Mistry P.,
Currie V.,
Super P.,
le Roux C. W.,
Tahrani A. A.,
Singhal R.
Publication year - 2018
Publication title -
clinical obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 12
eISSN - 1758-8111
pISSN - 1758-8103
DOI - 10.1111/cob.12244
Subject(s) - medicine , diabetes mellitus , body mass index , adjustable gastric band , weight loss , blood pressure , laparoscopic adjustable gastric banding , type 2 diabetes mellitus , type 2 diabetes , surgery , complication , obesity , gastric bypass , endocrinology
Summary The long‐term outcomes of weight loss maintenance induced by laparoscopic adjustable gastric band (LAGB) followed by multidisciplinary medical care in patients with type 2 diabetes mellitus (T2DM) (beyond 3 years) are scarcely reported. Study aims were to determine the longer term metabolic outcomes following LAGB combined with medical care in patients with T2DM. This is a longitudinal analysis of 200 adults with T2DM who had LAGB between 2003 and 2008 and were followed up till 2013 at a single bariatric unit in a tertiary UK centre. A total of 200 patients (age 47 ± 9.7 years; body mass index [BMI] 52.8 ± 9.2 kg m −2 ; glycosylated haemoglobin (HbA1c) 7.9 ± 1.9% [62.8 mmol mol −1 ]; women, n = 123 [61.5%]; insulin treatment, n = 71 [35.5%]) were included. The mean follow‐up was 62.0 ± 13.0 months (range 18–84 months). There were significant reductions in body weight (−24.4 ± 12.3% [38 ± 22.7 kg]), HbA1c (−1.4 ± 2.0%), systolic blood pressure [BP] (−11.7 ± 23.5 mmHg), total cholesterol and triglyceride levels. The proportion of patients requiring insulin reduced from 36.2% to 12.3%. The overall band complication rate was 21% (21 patients). LAGB when combined with multidisciplinary medical care significantly improved metabolic outcomes in patients with T2DM independent of diabetes duration, and baseline BMI over 5 years. Diabetes duration and baseline BMI did not predict changes in glycaemic control, BP or lipids following LAGB.