Author(s): Ponce J, Haynes B, Paynter S, Fromm R, Lindsey B,
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Abstract BACKGROUND: Severe obesity is associated with type 2 diabetes and hypertension. Improvement in these comorbidities after surgically-induced weight loss has been documented, and laparoscopic adjustable gastric banding (LAGB) is an effective weight loss operation. METHODS: Of 840 patients who underwent Lap-Band, data are available in 402 out of 413 patients whose surgery took place at >/= 1 year ago. Preoperative and follow-up data were studied retrospectively to examine the effect of Lap-Band-induced weight loss on diabetes and hypertension. RESULTS: Of 413 patients with at least 1 year postoperative follow-up, 53 (12.8\%) were taking medications for type 2 diabetes preoperatively and 189 (45.7\%) were on antihypertensive medications. 66\% (n=35) of diabetic patients were also hypertensive. Resolution of diabetes was observed in 66\% at 1-year and 80\% at 2-year follow-up. HbA1c dropped from 7.25\% (5.6-11.0, n=53) preoperatively to 5.58\% (5.0-6.2, n=15) at 2 years after surgery. Hypertension resolved in 59.8\% and 74\% at 1 and 2 years, respectively. Percent excess weight loss (\%EWL) was lower for diabetic patients than for our cohort population (39.2\% vs 41.2\% at 1 year, 46.7\% vs 54.2\% at 18 months, and 52.6\% vs 63.3\% at 2 years, respectively). Patients in whom diabetes was improved but not resolved had lower \%EWL than did those whose diabetes went into remission (27.0\% at 1 year and 26.5\% at 2 years). Patients with the shortest duration of diabetes (<5 years) and better weight loss after surgery achieved higher resolution rates. CONCLUSIONS: Dramatic improvement in - and frequent resolution of - diabetes and hypertension have been observed as a result of weight loss after Lap-Band surgery.
This article was published in Obes Surg
and referenced in Translational Medicine