Impact of Sleeve Gastrectomy on Weight Loss, Glucose Homeostasis, and Comorbidities in Severely Obese Type 2 Diabetic Subjects

Abstract

This study was undertaken to assess medium-term effects of laparoscopic sleeve gastrectomy (LSG) on body weight and glucose homeostasis in severely obese type 2 diabetic (T2DM) subjects. Twenty-five obese T2DM subjects (10 M/15 F, age 45 ± 9 years, BMI 48 ± 8 kg/m2, M ± SD) underwent evaluation of anthropometric/clinical parameters and glucose homeostasis before, 3 and 9–15 months after LSG. Mean BMI decreased from 48 ± 8 kg/m2 to 40 ± 9 kg/m2 (P < .001) at 3 months and 34 ± 6 kg/m2 (P < .001) at 9–15 months after surgery. Remission of T2DM (fasting plasma glucose < 126 mg/dL and HbA1c < 6.5% in the absence of hypoglycemic treatment) occurred in all patients but one. There was a remarkable reduction in the percentage of patients requiring antihypertensive and hypolipidemic drugs. Our study shows that LSG is effective in producing a significant and sustained weight loss and improving glucose homeostasis in severely obese T2DM patients.

Remission of Metabolic Syndrome After Sleeve Gastrectomy

“…In our series, the short-term results are in line with those described in the literature, and good glycemic control persisted after a minimum follow-up of 24 months [13], thus confirming the midterm effectiveness of glycemic control described by other groups [10,19].…”

“…Some studies have shown that LSG is associated with a marked reduction in the secretion of ghrelin, an orexigenic peptide produced by the gastric fundus and involved in mealtime hunger regulation. Ghrelin also exerts several diabetogenic effects (increases in somatotropin/growth hormone, cortisol, and epinephrine); therefore, its suppression could contribute to improve glucose homeostasis [18,19].…”

Short- and Long-term Effects of Laparoscopic Sleeve Gastrectomy on Body Weight and Glucose Homeostasis in Diabetic Patients

“…In 2008, Vidal et al 14 had 39 (obese T2DM) patients with a mean BMI (51.9 ± 1.2) submitted to LSG and had 52 (obese T2DM) patients with a mean BMI (47.7 ± 0.7) submitted to GBP. At 12 months after surgery the % estimated weight loss (EWL) was (63 ± 2.89%) (66.06 ± 2.34%); p = 0.413 respectively, and in 2011, Nosso et al 17 had 25 (obese T2DM) subjects with a mean BMI was (48.8 kg/m 2 ) and were submitted to LSG. The mean BMI decreased to (39 ± 8 kg/m 2 ) (p < 0.001) and (34 ± 6 kg/m 2 ) (p < 0.001) at 3 months and (9-15) months after surgery respectively.…”

“…15 The LSG is a safe procedure in terms of nutritional status at odds with malabsorptive or mixed surgical procedures, which often lead to multiple nutritional consequences due to the bypass of duodenum and Jejunum. 16 Several studies done on effect of LSG on amelioration of T2DM, in 2011, Nosso et al 17 were women and 9 (30%) were men, and in Nosso et al 17 had 25 (obese T2DM) patients, of which 15 (60%) were women and 10 (40%) were men and all were submitted to LSG. While in our study the number of patients were 40, 31 (77.5%) were women and 9 (22.5%) were men and were submitted to LSG.…”

Can LigaSure™ be used to perform sleeve gastrectomy? – Tensile strength and histological changes

“…In fact, LSG has the advantage to be reportedly less invasive than GBP and BPD, and not inferior in terms of sustained weight loss (1).…”