Abstract
BackgroundOur aim is to evaluate the effects of High Resected Gastric Volume(HRGV) on poorly Type 2 Diabetes Mellitus(DM2) after Laparoscopic Sleeve Gastrectomy(LSG).Methods256 patients were divided into two groups according to the RGV: < 1500 mL(Group A: 131 pts) and > 1500 mL(Group B: 147 pts). % excess body mass index loss (%EBMIL), Fasting Blood Glucose (FBG), HbA1c, C peptide were assessed before surgery and at the 3rd day, 6th,12th,24th,36th month after LSG.ResultsA significant difference in %EBMIL between the two groups at 24 and 36 months was found. RGV was not significantly associated with DM2 in the multivariate logistic regression. FBG levels showed no differences between the two groups. A significant decrease of Hb1Ac at 6 and 12 months was found in group B. The C-peptide level showed a significant reduction at 6 and 12 months in group B.ConclusionThe HRGV may play a role in the regulation of the glucose metabolism in the first year after LSG without influence in poorly DM2 control. Further studies are needed to confirm these findings.
Highlights
Among all bariatric surgical procedures, the Laparoscopic Sleeve Gastrectomy (LSG) is one of the most effective for the long-lasting treatment of severe obesity and its related conditions [1]
Some authors adopted age, body mass index (BMI), Cpeptide level and duration of DM2 as predicting factors for the glycemic control after LSG [3], but currently there are some Authors [4,5,6] in literature reports that compare the resected gastric volume (RGV) with DM2 control with different results
Other inclusion criteria were the following: diabetes duration less than 10 years since evidence in the literature suggests that DM lasting for more than 10 years is a negative prognostic factor for LSG effects on diabetes [6]; age between 20 and 60 years old; no immunosuppressive therapy; a poorly controlled DM2 defined by a glycated hemoglobin A1c (HbA1c) levels ≥7% and Fasting Blood Glucose (FBG) > 100 mg/
Summary
Among all bariatric surgical procedures, the Laparoscopic Sleeve Gastrectomy (LSG) is one of the most effective for the long-lasting treatment of severe obesity and its related conditions [1]. Some authors adopted age, body mass index (BMI), Cpeptide level and duration of DM2 as predicting factors for the glycemic control after LSG [3], but currently there are some Authors [4,5,6] in literature reports that compare the resected gastric volume (RGV) with DM2 control with different results. No study shows if this correlation exists for high-volume gastric resection (HGVR). The aim of this prospective observational study was to establish a correlation between HRGV and DM2 control in a cohort of 256 patients during the first 3 years after surgery. Our aim is to evaluate the effects of High Resected Gastric Volume(HRGV) on poorly Type 2 Diabetes Mellitus(DM2) after Laparoscopic Sleeve Gastrectomy(LSG).
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