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

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 kgm(-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 18-84months). 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.