title: Laparoscopic adjustable gastric banding and progression from impaired fasting glucose to diabetes.
abstract: OBJECTIVE
  Obesity and dysglycaemia are major risk factors for type 2 diabetes. We determined if obese people undergoing laparoscopic adjustable gastric banding (LAGB) had a reduced risk of progressing from impaired fasting glucose (IFG) to diabetes.
  
  
  METHODS
  This was a retrospective cohort study of obese people with IFG who underwent LAGB. Weight and diabetes outcomes after a minimum follow-up period of 4 years (mean ± SD 6.1 ± 1.7 years) were compared with those of Australian adults with IFG from a population-based study (AusDiab).
  
  
  RESULTS
  We identified 281 LAGB patients with baseline IFG. Their mean ± SD age and BMI were 46 ± 9 years and 46 ± 9 kg/m(2), respectively. The diabetes incidence for patients in the lowest, middle and highest weight loss tertile were 19.1, 3.4 and 1.8 cases/1,000 person-years, respectively. The AusDiab cohort had a lower BMI (28 ± 5 kg/m(2)) and a diabetes incidence of 12.5 cases/1,000 person-years. This increased to 20.5 cases/1,000 person-years when analysis was restricted to the 322 obese AusDiab participants, which was higher than the overall rate of 8.2 cases/1,000 person-years seen in the LAGB group (p = 0.02). Multivariable analysis of the combined LAGB and AusDiab data suggested that LAGB was associated with ∼75% lower risk of diabetes (OR 0.24 [95% CI 0.10, 0.57], p = 0.004).
  
  
  CONCLUSIONS
  In obese people with IFG, weight loss after LAGB is associated with a substantially reduced risk of progressing to diabetes over ≥4 years. Bariatric surgery may be an effective diabetes prevention strategy in this population.
authors: Centre for Obesity Research and Education (CORE), Monash University at The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
authors: John M
authors: JM
authors: Wentworth
authors: Tamishta
authors: T
authors: Hensman
authors: Julie
authors: J
authors: Playfair
authors: Cheryl
authors: C
authors: Laurie
authors: Matthew E
authors: ME
authors: Ritchie
authors: Wendy A
authors: WA
authors: Brown
authors: Stewart
authors: S
authors: Skinner
authors: Jonathan E
authors: JE
authors: Shaw
authors: Paul E
authors: PE
authors: O'Brien
mesh_terms: D000328:Adult; D001315:Australia; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D018450:Disease Progression; D005215:Fasting; D005260:Female; D015391:Gastroplasty / Q000379:methods; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human