| Objective Through the levels (including:weight (kg) and body mass index, BMI) and excess weight loss before and after laparoscopic adjustable gastric banding in treatment of obesity with type 2 diabetes obesity, we confirm the short-term outcome of weight loss, and through the levels of the fasting blood glucose (FBG), fasting serum insulin (FINS), C peptide, and glycosylated hemoglobin (HbAlc) of pre-operation and post-operation,we define the short-term outcome in treatment of type 2 diabetes. We explore the related mechanism by examining the serum Leptin, glucagons-like peptide-1(GLP-1) and Ghrelin levels before and after laparoscopic adjustable gastric banding (LAGB) in the treatment of obesity patients with type 2 diabetes mellitus (T2DM), as well as analyze the correlation of index changes between the serum Leptin, GLP-1,Ghrelin and the diabetes-related indexes.Methods 20 cases of obesity with T2DM were diabetes group,20 cases of simple obesity patients were control group. We examine the fasting serum Leptin, GLP-1 and Ghrein levels preoperatively and 1,3,6,9,12 months after LAGB by using the Enzyme-Linked-Immunosorbent Assay (ELISA); we examine the fasting serum insulin (FINS), C-peptide, glycated hemoglobin (HbAlc) levels by using electrochemiluminescence; we use oxidase tests FBG levels; While we monitor body weight and calculating body mass index(BMI). We use pearson method to test correlation between the serum Leptin, GLP-1 and Ghrein levels and diabetes-related indexes. Results All the 40 patients lost weight, with BMI decreased from preoperative (38±5) kg/m2 to postoperative (30±4) kg/m2, (29±6) kg/m2and (28±7) kg/m2 respectively at 6th,9th and 12th month (P<0.05). The mean excess weight loss at 6th,9th and 12th month postoperatively was 29%±10%,31%±12% and 36%±17% respectively. At 12 months,20% of patients had> 50% excess weight loss. The serum FBG, FINS, insulin resistance index [HOMA-IR= FINS (mU/L)×FBG (mmol/L)/22.5], HbAlc, and C-peptide preoperative levels of the diabetes patients group were significantly higher (P<0.01) than the preoperative levels of control group. The serum Leptin, GLP-1, Ghrelin levels had no significant difference between the two groups before LAGB (P>0.05). The serum FBG and C-peptide levels of the diabetes patients group decreased significantly post-operative 3rd month (P＜0.05). The FBG levels ((8.5±3.0) mmol/L)were decreased significantly at 6th month,9th and 12th month ((6.5±1.0),(6.3±0.8) and (6.2±0.8) mmol/L) after LAGB. The levels of FINS, and HbAlc decreased significantly from 1st month postoperatively (P＜0.05), and the FBG levels returned to the normal ranges from the 3rd month. The serum Leptin levels declined gradually postoperative at 1st,3rd,6th,9th and 12th month between the two groups, while the serum GLP-1, Ghrelin levels increased gradually. There were significant positive correlation between the serum Leptin levels and the FBG, FINS, HbAlc, C-peptide levels respectively. As well as the serum Ghrelin and GLP-1 levels respectively had significant negative correlation with the FBG, FINS, HbAlc, C-peptide levels.Conclusions LAGB is effective in treatment of obesity and T2DM. The Blood sugar of obesity patients with type 2 diabetes was relieved or cured significantly. The possible mechanism is through increasing the serum levels of GLP-1, Ghrelin and reducing the serum Leptin levels, reducing insulin resistance, so as to reduce blood sugar.
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