MedWire News: Study results show that laparascopic adjustable gastric banding (LAGB) improves symptoms of Type 2 diabetes in the long term, but rarely leads to prolonged remission in patients with long-standing Type 2 diabetes.
Various types of bariatric surgery have been shown to dramatically reduce and to a large extent resolve symptoms of Type 2 diabetes, as reported by MedWire News.
However, whether such remission is a temporary or permanent outcome of bariatric surgery is less clear.
In this study, François Pattou (Université Lille-Nord de France, France) and team assessed the long-term, 5-year efficacy of LAGB surgery for reducing or resolving symptoms in patients with Type 2 diabetes (n=22) or impaired fasting glucose (IFG; n=51).
At baseline, the patients’ mean body mass index (BMI) was 48.3 kg/m2 and they were aged 39.9 years on average.
At 5 years after LAGB, the patients with IFG and Type 2 diabetes had lost a mean 41% of their excess weight. As a result, there were significant improvements in glycated hemoglobin (HbA1c), fasting and postprandial blood glucose, insulin, triglycerides, and liver steatosis among these individuals.
Insulin sensitivity, β-cell function, disposition index, high-density lipoprotein cholesterol, and Nottingham Health Profile quality of life had also significantly increased from baseline at 5 years in patients with IFG and Type 2 diabetes.
Good glycemic control, defined as an HbA1c of 7.0% or less, was seen in 13 diabetes patients at study completion, but only four had maintained complete remission of Type 2 diabetes.
Of note, patients with a long duration of diabetes, poor preoperative glucose control, and poor β-cell function at baseline had the worst outcome.
“For patients with advanced Type 2 diabetes, gastric bypass or other procedures that can restore incretin secretion and/or modify intestinal gluconeogenesis may be more appropriate,” conclude the authors in the British Journal of Surgery.
“In patients with IFG, where the risk of developing diabetes after LAGB is low, the balance between benefits and risks of the various surgical approaches should be compared in controlled prospective studies,” they add.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
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