Gastric Banding, Metformin Similar for Improving Glycemia

TUESDAY, Oct. 16, 2018 — In adults with moderate obesity and either impaired glucose tolerance (IGT) or recently diagnosed mild type 2 diabetes (T2D), gastric banding and metformin are similarly effective for slowing disease progression over a two-year period, according to a study published online Oct. 3 in Diabetes Care.

Anny H. Xiang, Ph.D., from Kaiser Permanente Southern California in Pasadena, and colleagues randomly assigned 88 adults (aged 21 to 65 years) with moderate obesity (body mass index 30 to 40 kg/m2) and IGT or recently diagnosed mild T2D to either gastric banding or metformin therapy for two years to compare their impact on β-cell function.

The researchers found that at 24 months, the band group lost 10.7 kg and the metformin group lost 1.7 kg (P < 0.01). Furthermore, in the band group, insulin sensitivity increased 45 percent compared with 25 percent in the metformin group (P = 0.3 between groups). After adjustment for insulin sensitivity, steady-state C-peptide fell slightly in each group (P = 0.34 between groups) and acute C-peptide response to arginine at maximum glycemic potentiation fell significantly in the metformin group (P = 0.002) but not in the band group (P = 0.25 between groups). At 12 and 24 months, hemoglobin A1c fell in the band group (P < 0.004), but it fell only at 12 months (P < 0.01) in the metformin group (P > 0.14 between groups). At 24 months, normoglycemia was present in 22 and 15 percent of those in the band and metformin groups, respectively (P = 0.66 between groups).

“Gastric banding and metformin had similar effects to preserve β-cell function and stabilize or improve glycemia over a two-year period in moderately obese adults with IGT or recently diagnosed, mild T2D,” the authors write.

Several authors disclosed financial ties to pharmaceutical and medical device companies, including Allergan Corp. and Apollo Endosurgery, which supported the study.

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Posted: October 2018

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