Role of sleeve gastrectomy in control of type 2 diabetes − a prospective clinical study

Abstract

Background Bariatric surgery has prompted weight loss and improved glycemic control in obese patients with high prevalence of type 2 diabetes mellitus (DM) through different techniques, increasing the popularity of bariatric and metabolic operations. Surgeons are faced with patients with relatively more sever type 2 DM disease. Aim The aim was to determine the efficacies of weight-reducing operations on DM control, especially laparoscopic sleeve gastrectomy (LSG), and to explore the correlation between high level of preoperative Hba1c as well as preoperative morbidity and postoperative outcomes after LSG. Patients and methods A prospective study was conducted between August 2015 and August 2017 at Al-Zahra University hospital. A total of 40 patients were included in this study with morbid obesity with BMI ranged from 35 to 45 kg/m2 and aged ranged from 30–55 years old. They had poorly controlled type 2 DM with hemoglobin A1C more than 7.5% after conventional treatment. All patients were operated by the same surgeon to avoid any procedural biasness. At each follow-up visit, weight loss and glycemic control status were evaluated. Result We included 40 patients who underwent LSG, and all completed 12 months of follow-up regarding remission of type 2 DM. In relation to glycemic control, the procedure demonstrated remission of DM up to 60% after 1 year of surgery. Conclusion Bariatric surgery (LSG) is not only a weight reduction surgery but a metabolic surgery, which can cure most of the metabolic syndrome. It is considered the most-effective long-term treatment modality of type 2 diabetes in obese patients.