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Laparoscopic sleeve gastrectomy for the treatment of diabetes mellitus type 2 patients—single center early experience

  
@article{GS11803,
	author = {Piotr Major and Michal Wysocki and Michał Pędziwiatr and Piotr Małczak and Magdalena Pisarska and Andrzej Budzyński},
	title = {Laparoscopic sleeve gastrectomy for the treatment of diabetes mellitus type 2 patients—single center early experience},
	journal = {Gland Surgery},
	volume = {5},
	number = {5},
	year = {2016},
	keywords = {},
	abstract = {Background: In recent years, laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly used primary bariatric procedures for morbid obesity. While laparoscopic Roux-en-Y gastric bypass (LRYGB) has well documented positive clinical influence on type 2 diabetes, the role of LSG in diabetes treatment is debatable. The main aim of this study is to present our early experience in LSG as a method of bariatric treatment in patients with type 2 diabetes or abnormalities in glucose homeostasis. 
Methods: Prospectively collected data of patients operated for morbid obesity at the 2nd Department of Surgery. The study was designed to assess the influence of LSG on type 2 diabetes and glucose homeostasis. The primary endpoint was the diabetes type 2 remission. Secondary endpoint was the change of glucose metabolism parameters after LSG. Patients were assessed preoperatively and allocated to two groups: group 1—with any preoperative abnormalities in glucose homeostasis (prediabetes, diabetes) and group 2—with non-elevated fasting glucose level. During follow-up (6 months after surgery) all glucose homeostasis parameters were analyzed again. One hundred and thirty-six patients after LSG were enrolled in the study (90 females, 46 males; mean age 40.5±9.9 years). Preoperative abnormalities in glucose homeostasis were confirmed in 64 (47%) patients. Twenty (15%) patients in this group had diabetes. 
Results: We observed significant reduction of body mass index (BMI) after surgery. Mean percent of EBMIL for all groups after 6 months from surgery was 59.90% (46.75–69.28%). There were no full remissions after surgery in patients with preoperative diabetes. We found significant improvement in biochemical markers of glucose homeostasis. We observed significant reduction of HbA1c% after surgery in both groups. The level of postoperative HbA1c% was related to BMI loss after surgery. 
Conclusions: LSG leads to significant improvement in biochemical glucose homeostasis and can be considered as a method of treatment in morbidly obese patients with glucose metabolism abnormalities. LSG as a method of treatment for patients with clinical type 2 diabetes still needs some further observation.},
	issn = {2227-8575},	url = {https://gs.amegroups.org/article/view/11803}
}