Mid-Term Diabetes Remission Outcome in Patients with BMI ≤ 30kg/m2 Following Sleeve Gastrectomy.

Abstract

Bariatric and metabolic surgery is recommended for Asian patients with type 2 diabetes mellitus (T2DM) and BMI ≥ 27.5kg/m2. However, mid to long-term ·evidence is still lacking. Patients' data that underwent laparoscopic sleeve gastrectomy (SG) as the primary surgery at the Affiliated Hospital of Xuzhou Medical University were analyzed. Patients with T2DM diagnosed with either fasting blood glucose (FBG) ≥ 7.0mmol/L or glycosylated hemoglobin (HbA1c) level ≥ 7.0% and 27.5 ≤ BMI ≤ 30kg/m2 were included. 24 patients (7 male and 17 female) were included in this study. With a mean follow-up duration of 4.5 ± 1.1years, the mean percentage of total weight loss (%TWL) was 14.4 ± 6.7%. Postoperatively, nine patients (37%) still required oral anti-diabetic medications, while no patients used insulin. FBG and HbA1c levels declined to 6.3 ± 1.5mmol/L and 6.0 ± 1.0%, respectively. Fifteen patients (63%) were with HbA1c levels < 7% and without medication requirements, five patients (21%) were with HbA1c levels < 7% with the help of oral anti-diabetic medication, and four patients (16%) were with HbA1c levels > 7% with the help of oral anti-diabetic medication. Our study provides further evidence that SG could result in both T2DM improvement and remission in patients with BMI ≤ 30kg/m2. Longer follow-up duration and larger sample will be needed in the future.