Efficacy comparison of laparoscopic sleeve gastrectomy in type 2 diabetes patients with a BMI 30-34.9kg/m2 versus BMI < 30kg/m2.

Abstract

Laparoscopic sleeve gastrectomy (LSG) is safe and effective in type 2 diabetes mellitus (T2DM) with body mass index (BMI) ≥ 35kg/m2. However, the effect and safety of LSG in the treatment of T2DM patients with BMI less than 35kg/m2, especially in patients with BMI less than 30kg/m2, are still debatable. A total of 51 T2DM patients with BMI less than 35kg/m2 treated successfully with LSG were included in our study. All patients were divided into two groups for subgroup analysis, namely group A (BMI 23.23-29.97kg/m2) and group B (BMI 30.0-34.9kg/m2). The weight loss and diabetic characteristics of LSG in the two groups at 3months, 6months, and 12months after operation were compared, respectively. In group A, the complete remission rates of T2DM were 20%, 36%, and 44% at 3, 6, and 12months after operation, respectively. In group B, the complete remission rates of T2DM were 30.8%, 61.5%, and 88.5% at 3, 6, and 12months after operation, respectively. Besides, none of the patients with a duration more than 15years achieved complete remission. For T2DM patients with BMI < 30kg/m2 at 12months after LSG, the complete remission rate of T2DM was 15.4% in patients with ABCD scores ≤ 2, and the complete remission rate of T2DM was 100% in patients with ABCD scores ≥ 5. LSG is safe and effective for T2DM patients with BMI less than 35kg/m2 in the short-term. However, the complete remission rate of T2DM in patients with BMI less than 30kg/m2 is far from the diabetes patients with BMI at 30-34.9kg/m2.