Impact of Gastric Banding Versus Metformin on ß-Cell Function in Adults With Impaired Glucose Tolerance or Mild Type 2 Diabetes.
Diabetes Care
; 41(12): 2544-2551, 2018 12.
Article
en En
| MEDLINE
| ID: mdl-30282699
ABSTRACT
OBJECTIVE:
Type 2 diabetes (T2D) results from progressive loss of ß-cell function. The BetaFat study compared gastric banding and metformin for their impact on ß-cell function in adults with moderate obesity and impaired glucose tolerance (IGT) or recently diagnosed, mild T2D. RESEARCH DESIGN ANDMETHODS:
Eighty-eight people aged 21-65 years, BMI 30-40 kg/m2, with IGT or diabetes known for <1 year, were randomized to gastric banding or metformin for 2 years. Hyperglycemic clamps (11.1 mmol/L) followed by arginine injection at maximally potentiating glycemia (>25 mmol/L) were performed at baseline, 12 months, and 24 months to measure steady-state C-peptide (SSCP) and acute C-peptide response to arginine at maximum glycemic potentiation (ACPRmax) and insulin sensitivity (M/I).RESULTS:
At 24 months, the band group lost 10.7 kg; the metformin group lost 1.7 kg (P < 0.01). Insulin sensitivity increased 45% in the band group and 25% in the metformin group (P = 0.30 between groups). SSCP adjusted for insulin sensitivity fell slightly but not significantly in each group (P = 0.34 between groups). ACPRmax adjusted for insulin sensitivity fell significantly in the metformin group (P = 0.002) but not in the band group (P = 0.25 between groups). HbA1c fell at 12 and 24 months in the band group (P < 0.004) but only at 12 months (P < 0.01) in the metformin group (P > 0.14 between groups). Normoglycemia was present in 22% and 15% of band and metformin groups, respectively, at 24 months (P = 0.66 between groups).CONCLUSIONS:
Gastric banding and metformin had similar effects to preserve ß-cell function and stabilize or improve glycemia over a 2-year period in moderately obese adults with IGT or recently diagnosed, mild T2D.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Gastroplastia
/
Intolerancia a la Glucosa
/
Diabetes Mellitus Tipo 2
/
Células Secretoras de Insulina
/
Metformina
Tipo de estudio:
Clinical_trials
Límite:
Adult
/
Aged
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Diabetes Care
Año:
2018
Tipo del documento:
Article