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

Research output: Contribution to journalArticlepeer-review

Authors

  • P Mistry
  • V Currie
  • P Super
  • C W le Roux
  • R Singhal

Colleges, School and Institutes

External organisations

  • Upper GI Unit and Minimally Invasive Unit, Heart of England NHS Foundation Trust, Birmingham, UK.
  • Department of Pathology, University College Dublin, Dublin, Ireland.
  • Institute of Metabolism and Systems Research, The University of Birmingham.
  • Department of Diabetes and Endocrinology, Heart of England NHS Foundation Trust, Birmingham
  • Centre for Endocrinology; Diabetes and Metabolism; Birmingham Health Partners; Birmingham B15 2TH UK

Abstract

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.

Details

Original languageEnglish
JournalClinical Obesity
Early online date4 Mar 2018
Publication statusE-pub ahead of print - 4 Mar 2018