Diabetologia

, Volume 57, Issue 3, pp 463–468

Laparoscopic adjustable gastric banding and progression from impaired fasting glucose to diabetes

  • John M. Wentworth
  • Tamishta Hensman
  • Julie Playfair
  • Cheryl Laurie
  • Matthew E. Ritchie
  • Wendy A. Brown
  • Stewart Skinner
  • Jonathan E. Shaw
  • Paul E. O’Brien
Article

DOI: 10.1007/s00125-013-3129-0

Cite this article as:
Wentworth, J.M., Hensman, T., Playfair, J. et al. Diabetologia (2014) 57: 463. doi:10.1007/s00125-013-3129-0

Abstract

Aims/hypothesis

Obesity and dysglycaemia are major risk factors for type 2 diabetes. We determined if obese people undergoing laparoscopic adjustable gastric banding (LAGB) had a reduced risk of progressing from impaired fasting glucose (IFG) to diabetes.

Methods

This was a retrospective cohort study of obese people with IFG who underwent LAGB. Weight and diabetes outcomes after a minimum follow-up period of 4 years (mean ± SD 6.1 ± 1.7 years) were compared with those of Australian adults with IFG from a population-based study (AusDiab).

Results

We identified 281 LAGB patients with baseline IFG. Their mean ± SD age and BMI were 46 ± 9 years and 46 ± 9 kg/m2, respectively. The diabetes incidence for patients in the lowest, middle and highest weight loss tertile were 19.1, 3.4 and 1.8 cases/1,000 person-years, respectively. The AusDiab cohort had a lower BMI (28 ± 5 kg/m2) and a diabetes incidence of 12.5 cases/1,000 person-years. This increased to 20.5 cases/1,000 person-years when analysis was restricted to the 322 obese AusDiab participants, which was higher than the overall rate of 8.2 cases/1,000 person-years seen in the LAGB group (p = 0.02). Multivariable analysis of the combined LAGB and AusDiab data suggested that LAGB was associated with ∼75% lower risk of diabetes (OR 0.24 [95% CI 0.10, 0.57], p = 0.004).

Conclusions/interpretation

In obese people with IFG, weight loss after LAGB is associated with a substantially reduced risk of progressing to diabetes over ≥4 years. Bariatric surgery may be an effective diabetes prevention strategy in this population.

Keywords

Bariatric surgery Diabetes prevention Impaired fasting glucose Obesity 

Abbreviations

FPG

Fasting plasma glucose

IFG

Impaired fasting glucose

IGT

Impaired glucose tolerance

LAGB

Laparoscopic adjustable gastric banding

SOS

Swedish Obese Subjects

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • John M. Wentworth
    • 1
    • 2
  • Tamishta Hensman
    • 1
  • Julie Playfair
    • 1
  • Cheryl Laurie
    • 1
  • Matthew E. Ritchie
    • 2
    • 3
  • Wendy A. Brown
    • 1
  • Stewart Skinner
    • 1
  • Jonathan E. Shaw
    • 4
  • Paul E. O’Brien
    • 1
  1. 1.Centre for Obesity Research and Education (CORE)Monash University at The Alfred CentreMelbourneAustralia
  2. 2.Molecular Medicine DivisionWalter and Eliza Hall InstituteMelbourneAustralia
  3. 3.Department of Mathematics and StatisticsThe University of MelbourneMelbourneAustralia
  4. 4.Baker IDI Heart and Diabetes InstituteMelbourneAustralia

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