T2DM & SG: Diabetes duration as prognostic factor of cure

Objective of the study: To evaluate the efficacy of LSG on glucose homeostasis in morbidly obese subjects with Type 2 Diabetes Mellitus (T2DM) and to elucidate the role of disease duration on resolution.

Methods: From October 2002 to August 2009, 240 patients underwent LSG for morbid obesity. Fifty-eight patients presented T2DM: 15 of them had a diabetes duration >10 years (F/M 9/6, mean age 52.2±5.3, mean pre-operative BMI 44.9±6.7 Kg/m2): GROUP A; 43 patients had a diabetes duration <10 years (F/M 35/8, mean age 49.7±7, mean pre-operative BMI 46.9±11.7 Kg/m2): GROUP B.

Results: In GROUP A 11 patients were on oral hypoglycaemic agents and 4 on insulin therapy. In GROUP B 38 patients were treated with oral hypoglycaemic and 5 on insulin therapy.
At 3 months after LSG 49/58 patients (84.5%) discontinued the antidiabetic therapy. The 3 months post-operative data for each group are reported in table:

Follow-up: 3 monthsBMI (Kg/m2)Fasting Glycaemia (mg/dl)Cured patients (%)
GROUP A (n=15)44.9±6.736.1±4.2237.4±56.4101.5±18.36 (40)
GROUP B (n=43)46.9±11.737.6±6.7132.9±30.795.2±2243 (100)

However, in the “non cured” group the patients were more sensitive to lower doses of antidiabetic drugs. Significantly reduced dosages were able to obtain normal fasting glycaemia levels.

Conclusions: The LSG is effective in the treatment of obese patients with T2DM. Diabetes duration seem to be paramount prognostic factor, being 10 years a cut-off between a 100% cure and a less percentage of resolution.

Session: Poster

Program Number: P061

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