Gastric Band Surgery Leads to Improved Insulin Secretion in Overweight People with Type 2 Diabetes

Obes Surg. 2015 Dec;25(12):2400-7. doi: 10.1007/s11695-015-1716-5.

Abstract

Background: We aimed to determine the effects of laparoscopic adjustable gastric band (LAGB) on beta-cell function in overweight people with type 2 diabetes and to assess the relationship between baseline beta-cell function and glycemic outcomes.

Methods: We studied 44 overweight but not obese people with type 2 diabetes who participated in a randomized trial whose primary outcome was the rate of diabetes remission after 2 years of multidisciplinary diabetes care (MDC group) or multidisciplinary care combined with LAGB. Dynamic beta-cell function was assessed by intravenous glucose challenge, and basal beta-cell function (HOMA-B) and insulin sensitivity (HOMA-S) were determined using the homeostatic model.

Results: Twelve LAGB participants and two MDC participants were in diabetes remission at 2 years. HOMA-S and the C-peptide response to intravenous glucose increased significantly in LAGB but not in MDC participants. The insulin response to glucose did not change in LAGB participants, whereas their fasting C-peptide/insulin ratio increased. Baseline measures of beta-cell function correlated with diabetes remission but not with reduction in HbA1c following LAGB.

Conclusions: In overweight people with diabetes, LAGB improves endogenous beta-cell function after 2 years. Baseline beta-cell function correlated with diabetes remission, but not with HbA1c change following LAGB.

Keywords: Bariatric surgery; Beta-cell function; Diabetes remission; First-phase insulin release; IVGTT; Type 2 diabetes; Weight loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2 / surgery*
  • Female
  • Gastroplasty*
  • Glycated Hemoglobin / analysis
  • Humans
  • Insulin / metabolism*
  • Insulin Resistance
  • Insulin Secretion
  • Insulin-Secreting Cells / physiology*
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Remission Induction

Substances

  • Glycated Hemoglobin A
  • Insulin
  • hemoglobin A1c protein, human