Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Beta cell response to intravenous glucose improves following gastric band surgery and predicts diabetes remission: secondary outcomes of a randomised controlled trial. (#336)

John M Wentworth 1 2 3 , Paul E O'Brien 2
  1. WEHI, Parkville, VIC, Australia
  2. Monash University Centre for Obesity Research and Education, Prahran, Australia
  3. Royal Melbourne Hospital, Monash Centre for Obesity Research and Education and Walter and Eliza Hall Institute, Melbourne, VIC, Australia

Objective

To determine the effect of laparoscopic adjustable gastric banding (LAGB) on beta cell function.

Research Design and 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 two years of multidisciplinary diabetes care (MDC group) or multidisciplinary care combined with LAGB. Beta cell function was defined as the C-peptide response to intravenous glucose over 15 minutes, normalized to the glucose increment (insulinogenic index). Insulin sensitivity was determined by the homeostatic model and multiplied by the insulinogenic index to determine the disposition index.

Results

Twelve and two participants in the LAGB and MDC groups respectively were in diabetes remission at two years. Beta cell function and disposition index improved significantly in the LAGB group but not in MDC participants, and correlated robustly with beta cell function calculated using the homeostatic model (HOMA-B). Baseline HOMA-B, and insulinogenic and disposition indices were associated with diabetes remission following LAGB, whereas weight loss and diabetes duration were not. 

Conclusions

Beta cell function in overweight people with diabetes improves two years after gastric band surgery and predicts diabetes remission.