Control of type 2 diabetes after 1 year of laparoscopic adjustable gastric banding in the helping evaluate reduction in obesity (HERO) study. Issue 10 (9th June 2014)

• Record Type: Journal Article
• Authors: Edelman, S.; Ng‐Mak, D. S.; Fusco, M.; Ashton, D.; Okerson, T.; Liu, Q.; Jin, J.; Dixon, J. B.
• Is Part Of: Diabetes, obesity & metabolism. Volume 16:Issue 10(2014:Oct.)
• Page Start: 1009
• Page End: 1015
• Publication Date: 2014-06-09
• Subjects: Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.12313
• Languages: English
• ISSNs: 1462-8902

Abstract

<abstract abstract-type="main" id="dom12313-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="dom12313-sec-0001" sec-type="section"> <title>Aims</title> <p id="dom12313-para-0001">The 5‐year, open‐label, prospective, observational helping evaluate reduction in obesity (HERO) study (N = 1106) examines efficacy and safety of the LAP‐BAND AP<sup>®</sup> laparoscopic adjustable gastric band (LAGB) in obese patients. This interim analysis assessed the control of type 2 diabetes (T2D), 1 year after the implantation of the LAGB.</p> </sec> <sec id="dom12313-sec-0002" sec-type="section"> <title>Methods</title> <p id="dom12313-para-0002">Baseline T2D was defined by chart review or use of antidiabetic medications or haemoglobin A1c (HbA1c) ≥7.0%. Control of T2D at 1 year was defined as A1c <7.0% (with or without antidiabetic medications).</p> </sec> <sec id="dom12313-sec-0003" sec-type="section"> <title>Results</title> <p id="dom12313-para-0003">After 1 year, 187 of 273 patients with T2D at baseline had adequate data available to assess T2D status, of which 135 patients (72.2%) achieved target control of T2D compared with 42.8% control rate at baseline. Independent predictors of achieving target control at 1 year included the following: (i) shorter diabetes duration odds ratio (OR) 0.914 [95% confidence interval (CI), 0.839, 0.995, p = 0.038], (ii) not using insulin therapy OR 0.16 (95% CI, 0.06, 0.47, p < 0.001) and (iii) greater mean % weight loss OR 1.176 (95% CI, 1.093, 1.266, p < 0.001). Patients using insulin at baseline were 84% less likely to achieve control of T2D after 1 year; each additional year of diabetes at baseline reduced the likelihood of good control by 9%; and each 1% of weight loss increases the likelihood of good control by 18%. Rates of device‐related adverse events and reoperations were low and were not significantly different between patients with and without baseline T2D at 1 year.</p> </sec> <sec id="dom12313-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="dom12313-para-0004">Greater % weight loss, not using insulin therapy, and shorter disease duration predicted increased likelihood of target control of T2D, 1 year after implantation of the LAGB.</p> </sec> </abstract>