Effect of Lap-Band-induced weight loss on type 2 diabetes mellitus and hypertension.
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.
Ponce
Jaime
J
Dalton Surgical Group, P. C. and Hamilton Medical Center, Dalton, GA 30720, USA. jponce@dalton.net
Haynes
Beverly
B
Paynter
Steven
S
Fromm
Richard
R
Lindsey
Brooke
B
Shafer
Amanda
A
Manahan
Eric
E
Sutterfield
Christopher
C
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D015905:Gastric Balloon; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss