The Role of Gastric Balloon as an Adjunct to Lifestyle Modification in Weight Loss and Management of Type 2 Diabetes: A Prospective Study on Metabolic Outcomes and Patient Adherence

Background: Obesity is a major contributor to the development and progression of type 2 diabetes mellitus (T2DM). Although lifestyle modification remains the cornerstone of management, sustained weight loss is often difficult to achieve. The intragastric balloon has emerged as a minimally invasive adjunctive therapy to enhance weight reduction and improve metabolic outcomes. Objective: To evaluate the effectiveness of intragastric balloon therapy as an adjunct to lifestyle modification in achieving weight loss and improving glycemic control in patients with obesity and T2DM. Methods: This prospective interventional study included 255 adult patients with obesity (BMI ≥30 kg/m²) and established T2DM. All patients underwent endoscopic intragastric balloon placement combined with structured dietary, physical activity, and behavioral counseling. The balloon was removed after six months. Patients were followed for 12 months. Primary outcomes were percentage total body weight loss (%TBWL) and change in HbA1c at six months. Secondary outcomes included fasting blood glucose, BMI reduction, medication adjustments, and safety outcomes. Results: The mean baseline BMI was 34.8±3.9 kg/m² and mean HbA1c was 8.4±1.2%. At six months, mean %TBWL was 14.5±3.6%, and BMI decreased to 29.7±3.2 kg/m². HbA1c improved significantly to 7.1±0.9%. At 12 months, sustained %TBWL of 11.9±3.4% was observed, with HbA1c maintained at 7.3±1.0%. A total of 89.8% achieved ≥5% weight loss, and 65.9% required reduction in antidiabetic medications. Early intolerance symptoms occurred in 24.3%, while 4.3% required premature balloon removal. No major complications were reported. Conclusion: Intragastric balloon therapy combined with lifestyle modification resulted in significant weight loss, improved glycemic control, and reduced medication requirements with an acceptable safety profile. It represents an effective intermediate option between conservative therapy and bariatric surgery for patients with obesity-related T2DM.