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

Abstract

Objective: The aim of the study was to evaluate blood glucose, insulin resistance indices, and adipokine (leptin and diponectin) 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.