A clinical study on laparoscopic adjustable gastric banding in the treatment of morbid obesity with type 2 diabetes

Abstract

Objective To evaluate the efficacy of laparoscopic adjustable gastric banding (LAGB) in improving or resolving morbid obesity with type 2 diabetes (T2DM). Methods From October 2006 to December 2008, 15 morbidly obese patients with type 2 diabetes underwent LAGB. The body mass index (BMI), fasting (FBG) and postprandial blood glucose(PBG), medication for diabetes was assessed preoperatively and 1, 3, 6, 12 and 24 months after LAGB. The glycosylated serum protein (GSP) and serum insulin were measured at set intervals during a 12–month period after surgery. Results All the 15 patients lost weight, with BMI decreased from (41±7) kg/m2 before LAGB to (31±6) and (28±5) kg/m2 post–operative 12 and 24 month (t value was 2.104、3.862, respectively, P<0.05 and P<0.01). Compared to before the operation, the FBG level((11.2±1.4) mmol/L)were decreased significantly at 6th month, 12th and 24th month ((7.5±1.3) , (6.2±1.4) , (5.9±1.4) mmol/L) after LAGB (t value was 2.044, 2.416 and 2.473, all P<0.05). And the PBG level from (16.6±1.7) mmol/L (before the operation) decreased to (10.1±2.1) mmol/L (6th month), (7.7±2.6) mmol/L(12th month) and (7.4±2.3) mmol/L( 24th month, t value was 2.062, 3.073 and 3.084, all P<0.05). At 6th and 12th month after LAGB, the levels of GSP and serum insulin were decreased significantly. 8 cases stopped any medication at 24th month after surgery. Conclusion This clinical observational study suggests that LAGB is effective in inducing loss of weight and remission of T2DM. Key words: Obesity; Laparoscopy; Type 2 diabetes