Diabetes Outcomes More than a Decade Following Sustained Weight Loss After Laparoscopic Adjustable Gastric Band Surgery

  • John M. Wentworth
  • Chloe Cheng
  • Cheryl Laurie
  • Stewart Skinner
  • Paul R. Burton
  • Wendy A. Brown
  • Paul E. O’Brien
Original Contributions

Abstract

Background

Long-term outcome data are needed to define the role of bariatric surgery in type 2 diabetes (T2D). To address this, we collated diabetes outcomes more than a decade after laparoscopic adjustable gastric band (LAGB) surgery.

Method

Clinical and biochemical measures from 113 obese T2D patients who underwent LAGB surgery in 2003 and 2004 were analyzed. Diabetes remission was defined as HbA1c < 6.2% (44 mmol/mol) and fasting glucose < 7.0 mmol/L.

Results

Seventy-nine patients had weight data at 10 years and attained a median [Q1, Q3] weight loss of 16 [10, 21] percent. Sixty patients attended a follow-up assessment. Their baseline HbA1c of 7.8 [7.1, 9.3] percentage units (62 [54, 78] mmol/mol) had decreased to 6.6 [6.1, 8.4] (49 [43, 68] mmol/mol) despite no significant change in glucose-lowering therapy. Eleven patients (18%) were in diabetes remission and another 18 had HbA1c ≤ 6.5%. Significant improvements in physical measures of quality of life, blood pressure, and lipid profile were also observed but there was no change in the proportion of patients with albuminuria and a significant decline in estimated glomerular filtration rate. Twelve patients in the follow-up cohort (20%) required anti-reflux medication after surgery and 26 (43%) underwent gastric band revision surgery.

Conclusion

Weight loss for over 10 years after LAGB surgery delivers clinically meaningful improvements in HbA1c, blood pressure, lipids, and quality of life at the cost of a high rate of revision surgery and increased use of anti-reflux medication. These findings support the use of bariatric surgery as a long-term treatment for weight loss and wellbeing in patients with T2D.

Study Registration

Registered with the Australian Clinical trials registry as ACTRN12615000089538.

Keywords

Bariatric surgery Type 2 diabetes Obesity Long-term Outcomes Quality of life Laparoscopic adjustable gastric band 

Supplementary material

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ESM 1(DOCX 38.3 kb)
11695_2017_2944_MOESM2_ESM.docx (51 kb)
ESM 2(DOCX 50.6 kb)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Monash University Centre for Obesity Research and EducationMelbourneAustralia
  2. 2.Walter and Eliza Hall InstituteParkvilleAustralia
  3. 3.University of Melbourne Department of MedicineParkvilleAustralia

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