Prospective Study Comparing the effect of Laparoscopic Mini Gastric Bypass and Laparoscopic Sleeve Gastrectomy on Blood Glucose Level in Type 2 Diabetes Mellitus Obese Patients

Abstract

Abstract Background Type 2 diabetes mellitus (T2DM) is now a global health priority. The World Health Organization estimates that between 2000 and 2030, the number of diabetic patients will increase by 114%. T2DM and morbid obesity are conditions representing increasing public health threats. They are associated with significant morbidity and mortality, and despite lifestyle modifications and medical support, glycemic control remains difficult to achieve in obese diabetic patients. Objective To compare the effect of laproscopic mini gastric bypass and laproscopic sleeve gastrectomy in controlling type 2 DM obese patients. Patients and Methods Our study was conducted on 40 adult morbid obese patients with T2DM. Twenty patient underwent laparoscopic mini-gastric bypass and the other 20 patient underwent sleeve gastrectomy. All of these patients were followed up preoperative and postoperative at 1, 3, 6, 9 and 12 months by measuring BMI, EWL%, Fasting blood glucose level, 2 hours post prandial blood glucose level, HbA1C also postoperative gastrografin study to exclude complications. Results Our study demonstrated the superiority of MGB over SG in controlling T2DM along 1 year of follow up with lower 1 year HBA1C, FBG, 2HPP blood glucose level in bypass group in comparison with SG group. The results of our study regarding mini gastric bypass MGB patient group showed total remission rate (85%), the other 15% of patients achieved improvement of glycemic control, regarding antidiabetic treatment only 3 out of 20 needed postoperative treatment. The results of our study regarding sleeve gastrectomy patient group showed total remission rate (50%) the other 50% of patients achieved improvement of T2DM control, regarding antidiabetic treatment 9 out of 20 needed postoperative treatment. Conclusion late postoperative complications and long-term maintenance of glycemic control need to be determined by further studies on a larger scale of patients and bigger duration of follow up.