scholarly journals One Year Follow-up Results after Sleeve Gastrectomy in Type 2 Diabetes Mellitus Patients with Morbid Obesity

2016 ◽  
Vol 23 (2) ◽  
pp. 191-199
Author(s):  
Viorel Dejeu ◽  
Dănuţ-Aurel Dejeu ◽  
Paula Dejeu ◽  
Aurel Babeş
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Remission Rate ◽  
Glycosylated Hemoglobin ◽  
Diabetes Remission ◽  
One Year

AbstractBackground and aims: Bariatric surgery has been shown to be superior to nonsurgical approaches in terms of weight loss and remission of type 2 diabetes (T2DM) and metabolic syndrome. This prospective, single-center, follow-up study assessed percentage of excessive weight loss (%EWL), glycosylated hemoglobin (HbA1c) levels, prescribed antidiabetes drugs and diabetes remission rates in obese T2DM patients who underwent laparoscopic sleeve gastrectomy.Materials and methods: 81 patients were selected and data recorded preoperatively, 3, 6 and 12 months postoperatively.Results: We recorded - 69.3% EWL at 12 months (p<0.0001 compared to baseline) and a fall of HbA1c from 8.1±2.6% to 6.7±2.8% at 12 months postoperatively (p<0.0001). The percentage of patients with HbA1c<6.5% showed an increase to 40.7% (p=0.0004) and the one year T2DM remission rate was 20.9% (p=0.0012).Conclusions: Laparoscopic sleeve gastrectomy can significantly reduce the BMI, with near 70% EWL and near 21% T2DM remission rate in 1 year.

scholarly journals Type 2 Diabetes Remission 5 Years After Laparoscopic Sleeve Gastrectomy: Multicenter Cohort Study

2020 ◽  
Author(s):  
Magdalena Mizera ◽  
Michał Wysocki ◽  
Katarzyna Bartosiak ◽  
Paula Franczak ◽  
Hady Razak Hady ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Remission Rate ◽  
Cohort Analysis ◽  
Diabetes Remission ◽  
Multicenter Cohort

Abstract Purpose Bariatric surgery is no longer considered only as a weight loss surgery but also a way of treating obesity-related comorbidities such as type 2 diabetes mellitus (T2DM). Short-term T2DM remissions in patients undergoing laparoscopic sleeve gastrectomy (LSG) have been shown, but there are very few reports on the mid-term results. We aimed to assess the remission rate of T2DM in obese patients after LSG throughout 5-year follow-up. Materials and Methodology We performed a retrospective multicenter cohort analysis of 240 patients who underwent LSG. We assessed the remission rate of T2DM 1 year and 5 years after surgery. Results Forty-six percent of patients achieved T2DM remission 5 years after LSG. The remission group had better weight loss results (median% of total weight loss 5 years after: 30.1% (22.9–37.0) vs 23.0% (13.7–30.2), p < 0.001) and were significantly younger than the no remission group (43 (38–52) vs 52 (44–58) years, p < 0.001). Duration of T2DM was significantly shorter (2 (1–5) vs 5 (3–10) years, p < 0.001) with less insulin requirement and less diabetes-related complications (7.2% vs 19.8%, p < 0.001) and significantly lower median DiaRem score (4.0 (IQR 2.0–6.0) vs 12.0 (IQR 5.0–16.0), p < 0.001). Preoperative body mass index (BMI) had no effect on remission. Conclusions Our study suggests that diabetes remission after laparoscopic sleeve gastrectomy occurs frequently, and in the 5-year follow-up, it may remain at the level of 46%. We identified the age of patients, duration, and severity of T2DM as factors affecting mid-term diabetes remission. Nevertheless, further well-designed trials are needed to support our findings.

scholarly journals Fat-Free Mass and Skeletal Muscle Mass Gain Are Associated with Diabetes Remission after Laparoscopic Sleeve Gastrectomy in Males but Not in Females

2022 ◽  
Vol 19 (2) ◽  
pp. 978
Author(s):  
Ngan Thi Kim Nguyen ◽  
Nguyen-Phong Vo ◽  
Shih-Yi Huang ◽  
Weu Wang
Keyword(s):  
Skeletal Muscle ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Remission Rate ◽  
Fat Free Mass ◽  
Post Operation ◽  
One Year

Besides massive body weight loss, laparoscopic sleeve gastrectomy (LSG) causes massive lean mass, including fat-free mass (FFM) and skeletal muscle mass (SM) that present higher metabolic rates in males. This study examines sex differences in FFM and SM changes of type 2 diabetes (T2D) remission at 12 months post-LSG. This cohort study recruited 119 patients (53.7% females) with T2D and obesity (body mass index 42.2 ± 7.0 kg/m2) who underwent LSG. Fat-mass (FM) loss was higher in males than in females (−12.8 ± 6.2% vs. −9.9 ± 5.0%, p = 0.02) after one-year post-operation. Regardless of the weight-loss difference, males had higher FFM and SM gain than did females (12.8 ± 8.0 vs. 9.9 ± 5.0% p = 0.02 and 6.5 ± 4.3% vs. 4.9 ± 6.2%, p = 0.03, respectively). Positive correlations of triglyceride reduction with FM loss (r = 0.47, p = 0.01) and SM gain (r = 0.44, p = 0.02) over 12 months post-operation were observed in males who achieved T2D remission. The T2D remission rate significantly increased 16% and 26% for each additional percentage of FFM and SM gain one year after LSG, which only happened in males. Increased FFM and SM were remarkably associated with T2D remission in males, but evidence lacks for females.

scholarly journals New Metrics to Assess Type 2 Diabetes after Bariatric Surgery: The “Time-Within-Remission Range”

2020 ◽  
Vol 9 (4) ◽  
pp. 1070
Author(s):  
Ana de Hollanda ◽  
Albert Lecube ◽  
Miguel Angel Rubio ◽  
Enric Sánchez ◽  
Núria Vilarrasa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Diabetes Remission ◽  
Dynamic Responses ◽  
Type 2 Diabetes Remission

Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the “time-within-remission range” as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with a follow-up of 4.5 ± 2.5 years were included. Type of surgery, diabetes remission, recurrence of diabetes, “time-within-remission range” and key predictors of diabetes outcomes were assessed. All patients (70% women, 51.4 ± 9.2 years old, body mass index (BMI) 46.3 ± 6.9 kg/m2) underwent primary bariatric procedures. “Time-within-remission range” were 83.3% (33.3–91.6) after gastric bypass, 68.7% (7.1–87.5) after sleeve gastrectomy and 90% (83.3–92.8) after malabsorptive techniques (p < 0.001 for all). Duration of diabetes, baseline HbA1c and insulin treatment were significantly negatively correlated with the “time-within-remission range”. The association of bariatric techniques with “time-within-remission range”, using gastric bypass as a reference, were: odds ratio (OR) 3.70 (2.34–5.84), p < 0.001 for malabsorptive techniques and OR 0.55 (0.40–0.75), p < 0.001 for sleeve gastrectomy. Characteristics of type 2 diabetes powerfully influence the outcomes of bariatric surgery. The “time-within-remission range” unveils a superiority of gastric bypass compared to sleeve gastrectomy.

Laparoscopic sleeve gastrectomy: Effect on long-term remission for morbidly obese patients with type 2 diabetes at 5-year follow up

Surgery ◽  
2017 ◽  
Vol 162 (4) ◽  
pp. 857-862 ◽  
Author(s):  
Marius Nedelcu ◽  
Marcelo Loureiro ◽  
Mehdi Skalli ◽  
Florence Galtier ◽  
Audrey Jaussent ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Early Postoperative Outcomes and Medication Cost Savings after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients with Type 2 Diabetes

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Bethany J. Slater ◽  
Nina Bellatorre ◽  
Dan Eisenberg
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Cost Savings ◽  
Diabetes Remission ◽  
Medication Cost ◽  
Morbidly Obese ◽  
Model Assessment ◽  
Obese Patients

Background. We investigated the effect of laparoscopic sleeve gastrectomy (LSG) on morbidly obese diabetics and examined the short-term impact of LSG on diabetic medication cost.Methods. A prospective database of consecutive bariatric patients was reviewed. Morbidly obese patients with type 2 diabetes who underwent LSG were included in the study. Age, gender, body mass index (BMI), diabetic medication use, glucose, insulin, and HbA1c levels were documented preoperatively, and at 2 weeks, 2 months, 6 months, and 12 months postoperatively. Insulin resistance was estimated using the homeostatic model assessment (HOMA). Use and cost of diabetic medications were followed.Results. Of 178 patients, 22 were diabetics who underwent LSG. Diabetes remission was observed in 62% of patients within 2 months and in 75% of patients within 12 months. HOMA-IR improved after only two weeks following surgery (16.5 versus 6.6, ). Average number of diabetic medications decreased from 2.2 to <1, within 2 weeks after surgery; corresponding to a diabetes medication cost savings of 80%, 91%, 99%, and 99.7% after 2 weeks, 2 months, 6 months, and 12 months, respectively.Conclusion. Morbidly obese patients with diabetes who undergo LSG have high rates of diabetes remission early after surgery. This translates to a significant medication cost savings.

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