Vivek Bindal, MS, MRCS, FNB, Parveen Bhatia, MS, FRCS, Sudhir Kalhan, MS, Mukund Khetan, MS, Suviraj John, MS, FNB, Sushant Wadhera, MS. Ganga Ram Institute of Post Graduate Medical Education & Research
Introduction: We propose to analyze and attempt to understand the gut physiology and its metabolic alteration in Type 2 Diabetes Mellitus (T2DM) after Laparoscopic / Robotic Sleeve Gastrectomy (SG).
1. To evaluate the gut metabolic alterations in Indian Diabesitic patients undergoing SG
2. To correlate with the improvement in the anthropometric, diabetic indices and co-morbid conditions leading to betterment of quality of life indices
Methods: This is a prospective study being conducted in Sir Ganga Ram Hospital, New Delhi, India after IRB approval. Prospectively enrolled patients having BMI > 32.5 Kg/m2 with T2DM underwent Standardized SG. Baseline levels of Glucose, Insulin, C-Peptide were measured in Fasting (F) and Postprandial (PP) states. HbA1C levels are evaluated and HOMA-IR index calculated. Baseline fasting and PP levels of GHRELIN, GLP-1 & PYY are evaluated.
Results: A total of 32 patients have been enrolled in study thus far. The preliminary results show a significant decrease in BMI and a significant (p>0.001) correlation is found between fasting blood glucose-, insulin-levels with HbA1c. Furthermore, C-peptide decreases significantly within 1 month but increases as expected by 1 year. Also, as levels of Ghrelin decrease, GLP1 was observed to increase and PYY1 was also observed to decrease over a period of 6 months. Further Gut hormone data analysis is under process.
Conclusions: Our preliminary data shows that SG even though traditionally believed to be a restrictive procedure, does lead to metabolic alterations by producing changes in the gut hormones and resetting the deranged Gut- Endocrine Axis.