Laparoscopic gastric banding prevents type 2 diabetes and arterial hypertension in morbid (Grade 3) obesity : A 4 years study

Results: Obese subjects are at risk of type 2 diabetes (T2DM) and arterial hypertension, and lifestyle changes and pharmacologic treatment with metformin have been shown to prevent type 2 diabetes in obese IGT subjects. In this study we evaluated glucose tolerance (GT, through OGTT, 75 g), fasting insulin and blood glucose, HOMA index, and arterial hypertension at baseline and after 4 years in subjects treated with laparoscopic gastric banding (LAGB) and in subjects refusing LAGB (Table 1). Subjects undergoing LAGB had a significant decrease of BMI, HOMA index, and a significant improvement in GT (3 T2DM improved to IGT or NGT, 10 IGT improved to NGT, and only 1 subject progressed from NGT to IGT; no new cases of T2DM occurred, and only 1 subject developed hypertension. Subjects refusing LAGB had no change of BMI, HOMA index, and 6 subjects had deterioration of GT (4 new cases of T2DM, 2 progression from NGT to IGT; 3 IGT improved to NGT, and 1 T2DM improved to IGT) and of hypertension (7 new cases). Changes of GT and of hypertension were significant between the 2 groups of subjects (p < 0.05 and <0.01, respectively). At stepwise regression analysis, change of HOMA predicted change of GT and of hypertension. These data indicate that laparoscopic gastric banding prevents type 2 diabetes and arterial hypertension in morbid obesity at least for 4 years.