Effect of Bariatric Surgery on Glycaemic Control in King Fahad Hospital

Abstract

Background: Laparoscopic Sleeve Gastrectomy (LSG) is an approved procedure for weight reduction in obese patients. This outcome of weight loss is essential to achieve optimal control in patients with type 2 diabetes mellitus (T2DM). Objectives: This study was designed to evaluate the effect of LSG on glycemic control among a sample of obese patients in Al-Madinah Al-Munawwarah, Saudi Arabia, through assessment of reduction in hemoglobin A1c (HbA1c) associated with weight loss following LSG. Methods: In this cross-sectional study, we studied 102 patients with a body mass index (BMI) of ≥30 kg/m 2 and aged ≥18 years who underwent LSG between January 2017 and December 2019. Patient age, characteristics, preoperative and postoperative records of BMI and HbA1c were collected. The data of BMI and HbA1c were analyzed based on baseline and mean postoperative readings with variable postoperative visits after LSG. Results: There was a 30% reduction in BMI and a 26.4% reduction in HbA1c following LSG from baseline in all patients. We noted 44 patients achieved BMI <40kg/m 2 with HbA1c <6.5% and 32 patients achieved BMI <40kg/m 2 with HbA1c <5.7% within a mean follow-up time of 10 months. Conclusions: Laparoscopic Sleeve Gastrectomy (LSG) has a positive effect on glycemic control in obese patients in short term, evidenced by the significant reduction of weight and HbA1c. Larger longitudinal studies are needed to assess the long-term impact of LSG glycemic control and the related factors associated with maintaining weight reduction and optimal glycemic control in Saudi Arabia for patients with obesity.

Glycemic Control in the era of bariatric surgery: A systematic review and meta-analysis of published studies on the Saudi-Arabian population

“…Finally, three studies were involved. [ 1 14 15 ] The three studies were included in our analysis, Figure 1 . The summary and baseline characteristics of randomized controlled trials (RCTs) are mentioned in Tables 1 and 2 .…”

“…Three trials[ 1 14 15 ] studied the effect of LSG and RYGB on BMI, and a total of 760 patients were enrolled in those three trials. Results were significant as seen [mean difference (MD) 1.54; CI 0.76–2.32; P value 0.0001].…”

“…Obesity is one of the co-morbid diseases that have a devastating effect on the life quality all over the world. [ 1 ] Like other co-morbidities, such as non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD), and cancers, the incidence rate of obesity is still increasing. [ 2 ] At the level of Saudi Arabian population, obesity could reach all age groups more than 15 years old, especially females.…”

“…[ 3 ] The prevalence was found to be higher in females than in males with a percentage of 78% and 41%, respectively, according to 2022. [ 4 ] Many risk factors are accused directly to cause obesity comprising diet as a major risk factor, decreased activities,[ 1 ] and type 2 diabetes mellitus (T2DM). [ 5 ] According to World Health Organization (WHO), Saudi Arabia is the seventh globally and the second in the middle east to have a high incidence of diabetes and about 2 million with pre-diabetes.…”

Endoscopic Assessment Prior to Bariatric Surgery in Saudi Arabia

“…Bariatric surgery results in a greater and more durable weight loss than the best available nonsurgical interventions for obesity, regardless of the type of bariatric procedures used [6]. Beyond weight loss, the effect of bariatric surgery extends to enhancing glycemic control [7,8], improving lipid profile [9], controlling elevated blood pressure [10], achieving type 2 diabetes mellitus remission and metabolic syndrome resolution [11,12], alleviating obstructive sleep apnea [13], augmenting renal functions [14], treating nonalcoholic fatty liver disease [15], improving quality of life and body image [16], improving fertility and sexual health [17,18], lowering cardiovascular events [19], decreasing cancer risks [20], prolonging long-term survival [19], and decreasing medical cost [21].…”