Effects of laparoscopic gastric plication (LGP) in patients with type 2 diabetes, one year follow-up

Abstract

BackgroundObesity is a major risk factor for the development of type 2 diabetes mellitus. Surgery is one of the most effective treatments for morbid obesity. In a prospective cohort study, we examined the effects of Laparoscopic Gastric Plication (LGP) as a new restrictive technique on remission of type 2 diabetes mellitus.MethodsDuring six years of study from June 2007 through December 2013, 62 patients who underwent bariatric surgery were recruited for our study to determine the effects of weight loss. Sixty patients with diabetes mellitus type 2 were selected for a one year follow up period. The amount of weight loss, Fasting Blood Sugar (FBS), changes in the lipid profile, HbA1c and blood pressure were assessed during this period. The primary outcomes were safety and the percentage of patients experiencing diabetes remission.ResultsSixty patients with the mean age of 39.7 ± 12.8 years, ranging from 18 to 62 years, were enrolled in the study for an average 12 months of follow up. The maximal weight loss of 57 kg was achieved at average after six months. FBS significantly decreased during this period, and after one year, remission of diabetes was achieved in 92 % of patients. In five patients, diabetes was controlled with decrease in taking oral medications.ConclusionsLaparoscopic Gastric Plication (LGP) resulted in significant and sustained weight loss with minimal physiologic changes in gastrointestinal tract and ameliorated blood glucose control of type 2 diabetes in morbid obese patients.

Evaluation of Weight Reduction, Diabetic State and Satiety Hormones After Laparoscopic Greater Curvature Plication in Morbidly Obese Diabetic Patients

“…In summary, the present study demonstrated the efficacy of LGCP not only as a bariatric procedure but as a metabolic surgery for patient with type II DM as other authors have demonstrated [28,29]. These findings substantiate the preliminary observations by Bradnova et al [8] who studied the short-term metabolic effect of LGCP in diabetic patients.…”

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

“…Their findings correspond with those of the 2012 study of Talebpour et al of 800 LGCP patients who, at 5year follow-up, achieved 55.0% EWL (28.0-100.0%) [184]. In a 2015 report by Talebpour et al in 60 LGCP patients who had achieved a maximum weight loss of 57 kg at 6 months, 95.0% of T2DM patients attained resolution at 1 year follow-up, and 2/55 patients who experienced weight regain also regained their T2DM [187]. In the Dolezalova et al study, 58 patients (27.4%) had T2DM at baseline; at 5 years, 65.5% of T2DM was resolved.…”

Insulin Sensitivity and Secretion in Obese Type 2 Diabetic Women after Various Bariatric Operations

“…The underlying mechanisms leading to T2DM improvement/remission following more complex bariatric procedures such as the BPD are not fully clarified yet and appear to involve changes not only in insulin resistance but also in insulin and incretin secretion [ 4 , 5 ]. Novel bariatric procedures such as the laparoscopic gastric plication (P), also referred to as laparoscopic greater curvature plication, total gastric vertical plication, or gastric imbrication [ 5 , 6 , 7 , 8 ], recently has broadened the arsenal of metabolic surgery interventions for the treatment of obese T2DM patients. This newer procedure eliminates the greater gastric curvature and forms a gastric tube by laparoscopic plication/infolding of the greater gastric curvature through placement of one or two rows of non-absorbable sutures or staples, thus reducing the stomach volume and leading to a restrictive effect without utilizing implantable devices (e.g., gastric band), gastrectomy, or intestinal bypass.…”