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Cited by 129Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesDiabetes, Cardiovascular Risks, and Lipoproteins

Laparoscopic Gastric Banding Prevents Type 2 Diabetes and Arterial Hypertension and Induces Their Remission in Morbid Obesity

Pontiroli, Antonio E., Folli, Franco, Paganelli, Michele, Micheletto, Giancarlo, Pizzocri, Pierluigi, Vedani, Paola, Luisi, Francesca, Perego, Lucia +2 more·2005·Diabetes Care
DOI 10.2337/diacare.28.11.2703
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Abstract

OBJECTIVE—Lifestyle modifications and pharmacological interventions can prevent type 2 diabetes in obese subjects with impaired glucose tolerance. The aim of this study was to compare laparoscopic adjustable gastric banding (LAGB) and conventional diet (No-LAGB) in the prevention (primary intervention study; 56 vs. 29 patients) and remission (secondary intervention study; 17 vs. 20 patients) of type 2 diabetes and hypertension in grade 3 obesity in a 4-year study. RESEARCH DESIGN AND METHODS—The subjects (n = 122; age 48.5 ± 1.05 years; BMI 45.7 ± 0.67 kg/m2) underwent a diagnostic workup, including psychological and psychiatric assessments, in preparation for the LAGB procedure. Of the 122 subjects, 73 had the surgery (LAGB group). The control group (No-LAGB group) consisted of the 49 subjects who refused the surgery but agreed to be followed up; 6 of these subjects dropped out by the 2nd year of the study, so that the final number of patients was 73 and 43 in the LAGB and No-LAGB groups, respectively. All patients had a yearly visit and oral glucose tolerance test. RESULTS—From baseline to the end of the 4-year follow-up, BMI decreased from 45.9 ± 0.89 at baseline to 37.7 ± 0.71 kg/m2 in the LAGB group and remained steady in the No-LAGB group (from 45.2 ± 1.04 to 46.5 ± 1.37 kg/m2), with no significant differences between the primary and secondary intervention groups. In the primary intervention study, five of the No-LAGB subjects (17.2%) and none of the LAGB subjects (0.0%; P = 0.0001) progressed to type 2 diabetes; in the secondary intervention study, type 2 diabetes remitted in one No-LAGB patient (4.0%) and seven LAGB patients (45.0%; P = 0.0052). Hypertension occurred in 11 No-LAGB patients (25.6%) and 1 LAGB patient (1.4%; P = 0.0001) and remitted in 1 No-LAGB (2.3%) and 15 LAGB patients (20.5%; P = 0.0001). A study of body mass composition revealed a significant reduction of fat mass and a transitory, but not significant, decrease of fat-free mass in LAGB patients. CONCLUSIONS—In morbid obesity, sustained and long-lasting weight loss obtained through LAGB prevents the occurrence of type 2 diabetes and hypertension and decreases the prevalence of these disorders.

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Authors
Pontiroli, A. E., Folli, F., Paganelli, M., Micheletto, G., Pizzocri, P., Vedani, P., Luisi, F., Perego, L., Morabito, A., & Bressani Doldi, S.
Affiliations
  • University of Milan (IT)
  • IRCCS Ospedale San Raffaele (IT)
  • Istituto Clinico Sant'Ambrogio (IT)
  • Dipartimento di Scienze Chirurgiche, Istituto Clinico Sant Ambrogio, Milan, Italy
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2005-11-01
Volume
28
Issue
11
Pages
2703-2709
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.28.11.2703
OpenAlex
W1982135701
Cited by
129
References
40
Citations by year
2025: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 4 · 2016: 4 · 2015: 3 · 2014: 7 · 2013: 11 · 2012: 8
FWCI
14.90
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
ZOLL Medical Corporation
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
laparoscopic adjustable gastric banding, type 2 diabetes prevention, diabetes remission, hypertension, morbid obesity, bariatric surgery, impaired glucose tolerance, weight loss, lifestyle modification, diet comparison, long-term follow-up, psychological assessment, psychiatric assessment, quality of life, body mass index, glycemic control, blood pressure control, postoperative quality of life
MeSH terms
Adult, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Hypertension, Italy, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Time Factors, Gastroplasty, Weight Loss, Body Mass Index, Prevalence, Case-Control Studies, Treatment Outcome

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