Sleeve Gastrectomy for Type 2 Diabetic Obese Patients

Marcos Berry, MD¹, Lionel Urrutia, MD¹, Patricio Lamoza², Alfredo Molina¹, Rodolfo Lahsen¹, Shirley Marquina¹. ¹Clinica Las Condes, ²Hospital de Maipu

Introduction: Morbidly obese patients with T2DM who undergo bariatric surgery have improvement or remission of their diabetes. We report our results in terms of type 2 diabetes(T2DM) control in obese patients after laparoscopic sleeve gastrectomy(LSG), analyzing the excess weight loss (EWL%), metabolic performance after surgery, and morbi-mortality.

Aim: Evaluate the results of metabolic control in the treatment of obese patients with T2DM undergoing LSG.

Methods: A prospective case series of obese, well-controlled T2DM patients underwent LSG consecutively between April 2006 and December 2013.

Results: 95 patients (5.92%) from a universe of 1605 subjected to LSG, 56 male and 39 female, mean age 49.48 years(24-70), were operated upon and underwent follow-up for a mean of 36 months (3 – 85). Mean preoperative BMI versus follow-up BMI were 36.43(30.2-51) and 26.2(24-28), respectively, and the mean EWL% was 77.57 %. Mean preoperative fasting glucose levels and HbA1C decreased from 144,53 mg%(84-250) to 95.1mg%(70-120) and from 7 %(5.2-11.6) to 5.79%(5.3-6.9), respectively. At follow-up, 89% of patients did not require further oral treatment for diabetes, while 11% witnessed a significant decrease in dosage of medication and/or were being progressively tapered off of medication.

Comorbidities: hemoperitoneum 1.05% and perigastric hematoma 1.05%; no mortality.

Discussion: LSG is a safe and an effective surgery for mild and well controlled T2DM patients, achieving a very good metabolic control. Further follow-up is necessary to evaluate long term results and may provide valuable information in optimizing patient selection for this procedure.

Keywords: Bariatric surgery, Morbid obesity, Sleeve gastrectomy, Remission, Type two diabetes.