Effects of gastric banding on glucose tolerance, cardiovascular and renal function, and diabetic complications: a 13-year study of the morbidly obese

Zakaria, Ahmed; Rossetti, Luca; Cristina, Maurizio; Veronelli, Anna; Lombardi, Federico; Saibene, Alessandro; Micheletto, Giancarlo; Pontiroli, Antonio E.

doi:10.1016/j.soard.2015.10.062

Cited by 22 publications

(31 citation statements)

References 39 publications

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“…Insulin sensitivity, assessed by HOMA-IR, Si from IVGTT and/or ISI during OGTT, improved after both types of surgery, confirming well-documented data after RYGB (21,22) or LAGB (23–25). Moreover, we show that the effect is a function of weight loss, independent of the surgery type.…”

Section: Discussionsupporting

confidence: 79%

Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect

et al. 2016

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OBJECTIVEThe superior effect of Roux-en-Y gastric bypass (RYGB) on glucose control compared with laparoscopic adjustable gastric banding (LAGB) is confounded by the greater weight loss after RYGB. We therefore examined the effect of these two surgeries on metabolic parameters matched on small and large amounts of weight loss.RESEARCH DESIGN AND METHODSSeverely obese individuals with type 2 diabetes were tested for glucose metabolism, β-cell function, and insulin sensitivity after oral and intravenous glucose stimuli, before and 1 year after RYGB and LAGB, and at 10% and 20% weight loss after each surgery.RESULTSRYGB resulted in greater glucagon-like peptide 1 release and incretin effect, compared with LAGB, at any level of weight loss. RYGB decreased glucose levels (120 min and area under the curve for glucose) more than LAGB at 10% weight loss. However, the improvement in glucose metabolism, the rate of diabetes remission and use of diabetes medications, insulin sensitivity, and β-cell function were similar after the two types of surgery after 20% equivalent weight loss.CONCLUSIONSAlthough RYGB retained its unique effect on incretins, the superiority of the effect of RYGB over that of LAGB on glucose metabolism, which is apparent after 10% weight loss, was attenuated after larger weight loss.

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Section: Discussionsupporting

confidence: 79%

Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect

et al. 2016

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“…After the removal of duplicates, the remaining 1333 articles were screened according to the inclusion criteria. Fourteen studies met the inclusion criteria. One publication was excluded because it measured differences only in severity of retinopathic changes according to the NSC‐UK without mentioning the exact stages.…”

Section: Resultsmentioning

confidence: 99%

“…Another problem was that the compliance of patients undergoing medical treatment had not been verified specifically in any of the studies. Five studies reported on adverse events in the surgery group, such as herniation, ulceration, infection or the need for reintervention, and only three studies reported on complications or side‐effects of medical treatment, such as adverse events related to medication or hypoglycaemia. Substantial loss to follow‐up was seen in three studies.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus

Billeter

Scheurlen

Probst

et al. 2018

British Journal of Surgery

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“…[17] Regarding diabetic complications, the effect of intervention weight loss is confused or null; a cohort study showed weight loss due to gastric banding has no unfavorable effect on kidney function and retinopathy and no effect on the prevention of arterial hypertension or cardiovascular disease. [18] A meta-analysis on glycemic control and weight loss in patients with T2DM showed that exercise training reduces hemoglobin A1c by an amount that should decrease the risk of diabetic complications, but no significant effect on weight loss was found. [19] Different from intervention weight loss, we focused on weight lost without lifestyle changes or other interventions before the diagnosis of T2DM.…”

Section: Discussionmentioning

confidence: 99%

Weight loss before a diagnosis of type 2 diabetes mellitus is a risk factor for diabetes complications

et al. 2016

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Effects of gastric banding on glucose tolerance, cardiovascular and renal function, and diabetic complications: a 13-year study of the morbidly obese

Cited by 22 publications

References 39 publications

Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect

Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect

Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus

Weight loss before a diagnosis of type 2 diabetes mellitus is a risk factor for diabetes complications

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