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

Abstract

Sleeve gastrectomy (SG) has become the most popular bariatric procedure. Although bariatric surgery is recommended for type 2 diabetes mellitus (T2DM) in Asian patients with BMI 27.5-32.4kg/m2, reported evidences, especially following SG, are still lacking. Patients' data from June 2016 to June 2018 that underwent SG as primary surgery at our setting were analyzed. Patients with T2DM, without insulin use and BMI 27.5-30kg/m2, were our main criteria. Preoperative and postoperative parameters were as such: age, BMI, T2DM duration, anti-diabetic medications, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), insulin, C-peptide, and homeostatic model assessment-insulin resistance (HOMA-IR). Follow-up duration was at 1, 3, 6, and 12months. Eighteen patients (7 male and 11 female) were presented for this study. The mean age and diabetes duration were 46.3 ± 11.9years and 31.8 ± 26.5months, respectively. The mean preoperative vs postoperative 12-month assessment was as such: BMI 29.3 ± 0.9 vs 23.9 ± 0.9kg/m2, FPG 8.4 ± 3.1 vs 5.6 ± 0.7mmol/L, HbA1c 8.3 ± 1.8 vs 5.9 ± 0.7%, insulin 103.9 ± 47.4 vs 53.9 ± 13.1pmol/L, C-peptide 1.90 ± 1.22 vs 1.08 ± 0.44ng/ml, and HOMA-IR 5.5 ± 4.0 vs 1.9 ± 0.6, all reached statistical significance (p value < 0.05). In short-term, and also under strict selection criteria, SG can result in both improvement and remission of T2DM in patients with BMI 27.5-30kg/m2. Larger sample size and longer follow-up duration will be needed in the future.