Remission of Type 2 Diabetes mellitus 1year after bariatric surgery in severely obese patients

Narong Boonyagard, MD, Pondech Vichajarn, Pakkavuth Chanswangphuvana, Krit Kitisin, Suppa-ut Pungpapong, Chadin Tharavej, Patpong Navicharern, Suthep Udomsawaengsup. King Chulalongkorn Memorial Hospital

Background & Objective :

Remission of Type 2 Diabetes mellitus (T2DM) after bariatric surgery was reported in many studies. Different types of bariatric operations offered varying degrees of T2DM remission. Our objective was to evaluate the effect of laparoscopic bariatric surgery on the control of T2DM in severely obese (BMI 35-50) patients at 1 year follow up in Thai population by comparing Laparoscopic Roux-en-Y gastric bypass (LRYGB) with Laparoscopic sleeve gastrectomy (LSG).

Methods :

We analyzed the data concerning 142 severely obese (BMI 35-50) who operated LRYGB or LSG between June 2006 and August 2013. Among them, 38 patients had diabetes before surgery and were included in the study, 22 had LRYGB and 16 had LSG. Evolutions of weight, BMI, percentage of excess weight loss (%EWL) and remission or improvement of T2DM were recorded during the first year of follow-up.

Result :

At one year after surgery all patient with T2DM were improved and 74% of patients presented with remission. Comparing between two groups, there was no significant difference between the groups in age, sex and BMI. There was no significant difference in term of 1-year T2DM remission between two groups (78% vs. 67% p=0.57). But LRYGB achieved higher %EWL than LSG (76.8%±20.8 vs. 54.8%±24.4 p=0.044).

Conclusion :

Bariatric surgery is effective for the improvement and remission of diabetes in patients who are severely obese. There was no significant difference in T2DM remission between the 2 techniques. So, severely obese with diabetes patients should be considered for laparoscopic obesity surgery as an early intervention.