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 months||BMI (Kg/m2)||Fasting Glycaemia (mg/dl)||Cured patients (%)|
|GROUP A (n=15)||44.9±6.7||36.1±4.2||237.4±56.4||101.5±18.3||6 (40)|
|GROUP B (n=43)||46.9±11.7||37.6±6.7||132.9±30.7||95.2±22||43 (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.
Program Number: P061