Comparison of Changes in Blood Glucose, Insulin Resistance Indices, and Adipokine Levels in Diabetic and Nondiabetic Subjects With Morbid Obesity After Laparoscopic Adjustable Gastric Banding

Objective. The aim of the study was to evaluate blood glucose, insulin resistance indices, and adipokine (leptin and adiponectin) levels in morbidly obese individuals with and without type 2 diabetes mellitus and to compare the changes in these parameters 1 year after laparoscopic adjustable gastric banding surgery.
Material and Methods. In total, 103 patients (37 subjects with and 66 subjects without type 2 diabetes mellitus) were studied preoperatively and again 1 year after laparoscopic adjustable gastric banding.
Results. One year after laparoscopic adjustable gastric banding, the leptin concentrations decreased significantly in both treatment groups, while the adiponectin levels increased significantly in the nondiabetic patients (11.19 μg/mL [SD 7.20] vs. 15.58 μg/mL [SD 7.8], P=0.003) and tended to increase in the group of the patients with type 2 diabetes mellitus (8.98 μg/mL [SD 6.80] vs. 13.01 μg/mL [SD 12.14], P>0.05). A considerable decrease in the insulin resistance indices was noted in the patients with type 2 diabetes mellitus 1 year after the intervention, and it was followed by a partial or complete remission of type 2 diabetes mellitus in 23 (85.19%) of the 27 investigated diabetic patients. The postoperative insulin resistance indices in the patients with type 2 diabetes mellitus became similar to the values in the nondiabetic subjects.
Conclusions. Weight loss after laparoscopic adjustable gastric banding is associated with a significant increase in adiponectin secretion in nondiabetic morbidly obese patients and with improvement in adiponectin secretion in type 2 diabetes individuals. In subjects with type 2 diabetes, this surgical intervention results in a significant reduction in blood glucose and insulin resistance.