IBC-Oxford University2023_BJSOral_6Five years Follow up after Surgical Treatment of Type 2 Diabetes with Laparoscopic Sleeve Gastrectomy associated with a Duodenal Ileal Interposition

Abstract

Abstract Introduction Type 2 diabetes mellitus (T2D) is a chronic disease, primarily caused by a combination of defective insulin secretion and the inability of insulin-sensitive tissues to respond to insulin. Laparoscopic sleeve gastrectomy associated with duodenal ileal interposition (SGDII) has been shown to be a feasible treatment option for patients with T2D, as it provides improvement and control of glycaemia, dyslipidaemia and arterial hypertension. The aim of this study was to evaluate the mid and long-term results of SGDII for the treatment of diabetic patients, considering diabetic remission, weight loss and postoperative complications. Materials and Methods Retrospective study with 96 patients with T2D submitted to SGDII, between 2010 and 2016. The glycated haemoglobin (HbA1c) value < 6.5%, without the use of hypoglycaemic agents, was considered as remission of T2D. Results The five years follow up demonstrated that 80% of patients had T2D remission at one year, 74.5% at three years and 61.8% at five years. The average duration of the disease was nine years and the mean glycated haemoglobin before surgery was 8.95%. Sixty-one patients (62.8%) were male, and 36 patients (37.2%) were female. The average age was 50.9 years. Median BMI was 33.43 kg/m2. The incidence of major postoperative complications in the first 30 days was 2.1%, with no mortality. Dyslipidaemia control was sustained, after five years, in 62% of the patients. Conclusion SGDII resulted in good glycaemic control at 5-years follow-up and represents a valid alternative for the treatment of T2D.