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