title: Gastric Band Surgery Leads to Improved Insulin Secretion in Overweight People with Type 2 Diabetes.
abstract: BACKGROUND
  We aimed to determine the effects of laparoscopic adjustable gastric band (LAGB) on beta-cell function in overweight people with type 2 diabetes and to assess the relationship between baseline beta-cell function and glycemic outcomes.
  
  
  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 2 years of multidisciplinary diabetes care (MDC group) or multidisciplinary care combined with LAGB. Dynamic beta-cell function was assessed by intravenous glucose challenge, and basal beta-cell function (HOMA-B) and insulin sensitivity (HOMA-S) were determined using the homeostatic model.
  
  
  RESULTS
  Twelve LAGB participants and two MDC participants were in diabetes remission at 2 years. HOMA-S and the C-peptide response to intravenous glucose increased significantly in LAGB but not in MDC participants. The insulin response to glucose did not change in LAGB participants, whereas their fasting C-peptide/insulin ratio increased. Baseline measures of beta-cell function correlated with diabetes remission but not with reduction in HbA1c following LAGB.
  
  
  CONCLUSIONS
  In overweight people with diabetes, LAGB improves endogenous beta-cell function after 2 years. Baseline beta-cell function correlated with diabetes remission, but not with HbA1c change following LAGB.
authors.affiliation: Centre for Obesity Research and Education (CORE), Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia. wentworth@wehi.edu.au.|Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, Australia. wentworth@wehi.edu.au.
authors.forename: John M
authors.initials: JM
authors.lastname: Wentworth
authors.affiliation: Centre for Obesity Research and Education (CORE), Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Playfair
authors.affiliation: Centre for Obesity Research and Education (CORE), Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Laurie
authors.affiliation: Centre for Obesity Research and Education (CORE), Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Brown
authors.affiliation: Centre for Obesity Research and Education (CORE), Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Burton
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Shaw
authors.affiliation: Centre for Obesity Research and Education (CORE), Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia.
authors.forename: Paul E
authors.initials: PE
authors.lastname: O'Brien
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D005260:Female; D015391:Gastroplasty; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012074:Remission Induction
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Bariatric surgery; Beta-cell function; Diabetes remission; First-phase insulin release; IVGTT; Type 2 diabetes; Weight loss