Abstract:
OBJECTIVE:Laparoscopic adjustable gastric banding (LAGB) is an established bariatric surgical procedure that produces meaningful weight loss and improvements in patients with type 2 diabetes mellitus (T2DM) and a body mass index (BMI) ≥ 30 kg/m2. This study examined the effect of LAGB on T2DM status in severely obese patients with T2DM. METHODS:This was a 2-year interim analysis of patients with T2DM who required daily hypoglycemic medication at baseline (N = 89) in the 5-year, open-label, prospective, observational LAP-BAND AP® EXperience (APEX) trial. Type 2 diabetes mellitus status was classified as "remission," "improved," "stable," or "worse" based on physician- and patient-reported changes in T2DM control and changes in hypoglycemic medication use. RESULTS:At baseline, 89 (22.5%) of 395 patients required daily hypoglycemic medication; 66 patients had data available after 2 years. Remission of T2DM occurred in 32 (48.5%) patients, improvement occurred in 31 (47.0%) patients, and no change occurred in 3 (4.5%) patients. Overall, 95.5% of patients experienced remission or improvement in T2DM status. Duration of T2DM in patients with remission or improvement after 2 years was 4.0 and 6.7 years, respectively (P = 0.082 between groups), and was associated with change in T2DM status (logistic regression, P = 0.069). Baseline BMI, change in BMI, and percent weight loss were not significantly different between the T2DM response groups. Percent excess weight loss was numerically, but not statistically significantly, greater in remitted (-56.1%) compared with the improved response (-42.9%) group (P = 0.134), and was correlated with change in T2DM status (logistic regression, P = 0.052). After 2 years, patients experienced remission or improvement of other obesity comorbidities. The rate of revisional surgery or explantation was 3.4%, and it was not significantly different between patients with and without T2DM (P = 0.687). CONCLUSION:Shorter duration of T2DM and greater percent excess weight loss were associated with an increased likelihood of remission or improvement in T2DM status through LAGB after 2 years. Laparoscopic adjustable gastric banding is a potential adjunctive treatment for obese patients with T2DM.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Edelman S,Bhoyrul S,Billy H,Cornell C,Okerson Tdoi
10.3810/pgm.2012.11.2590subject
Has Abstractpub_date
2012-11-01 00:00:00pages
73-81issue
6eissn
0032-5481issn
1941-9260journal_volume
124pub_type
临床试验,杂志文章,多中心研究abstract::Fever of unknown origin (FUO) remains a challenging clinical problem despite recent advances in diagnostic tools and techniques. Because primary care physicians are often the first ones to encounter a case of FUO, it is important that they be familiar with the best strategy and steps for confronting this problem initi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
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abstract::When a patient presents with a hard, painless lump in the neck, one should assume that it is a cancer and that it is metastatic from a primary lesion located above the clavicle. A careful physical examination with the appropriate instruments most often will determine the site of the primary lesion. Laryngograms or lat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11714054
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2009.11.2069
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698400
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11699070
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journal_title:Postgraduate medicine
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pub_type: 杂志文章,评审
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journal_title:Postgraduate medicine
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journal_title:Postgraduate medicine
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journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
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更新日期:2014-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-05-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.09.2213
更新日期:2010-09-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.09.83
更新日期:1996-09-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714699
更新日期:1977-12-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715687
更新日期:1981-02-01 00:00:00
abstract::Evaluation of the suicidal patient involves careful consideration of risk factors, including attention to subtle clues from the history, and mental status examination. The most urgent decision for the physician to make is whether or not to insist on hospitalization. If the need for inpatient care is uncertain, a "no s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699432
更新日期:1986-06-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715223
更新日期:1979-08-01 00:00:00
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journal_title:Postgraduate medicine
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doi:
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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更新日期:2010-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1991-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2000-05-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
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更新日期:1999-04-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715218
更新日期:1979-08-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698996
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11946003
更新日期:1995-06-01 00:00:00
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更新日期:2011-01-01 00:00:00
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pub_type: 杂志文章,评审
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