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Immediate Metabolic Response Following Sleeve Gastrectomy in Obese Diabetics

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Abstract

Background

Although laparoscopic sleeve gastrectomy (LSG) has been shown to have a long-term antidiabetic effect, little is known regarding the immediate response to surgery. This study’s objective was to evaluate the glycemic and lipid metabolic response in the first postoperative week.

Methods

The study included 21 obese diabetic participants. Glycemic markers, lipids, and hepatic function tests were measured just prior to surgery and at 1 week and 3 months postoperatively. Two participants were dropped prior to all measurements due to technical reasons, and two more were lost to follow-up.

Results

At 1 week after surgery, compared to preoperative baseline, we found reduced hemoglobin A1c (7.63 to 7.31, P < 0.001), insulin (24.96 to 10.92, P < 0.05), and borderline significant homeostatic model assessment insulin resistance (HOMA-IR, 9.48 to 3.91, P > 0.05). Low-density lipoprotein (LDL) cholesterol increased and high-density lipoprotein (HDL) cholesterol decreased. Three months after surgery, hemoglobin A1c, insulin, and HOMA-IR continued to decrease (6.05, 7.11, and 1.92, respectively, P < 0.05), with hemoglobin A1c correlated to weight loss (P < 0.05). Triglycerides, triglyceride to HDL ratio, and total cholesterol to HDL ratio also decreased, but there was no significant change in LDL cholesterol or HDL versus presurgery levels. Reduced triglyceride levels were correlated with reduced alanine transaminase (ALT) and gamma-glutamyl transpeptidase (GGT) (P < 0.05).

Conclusions

LSG is associated with marked antidiabetic effects as early as 1 week after surgery, unrelated to weight loss. The antidiabetic effect improves at 3 months. Triglyceride reduction was associated with improved hepatic functions, but cholesterol did not show a meaningful reduction.

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Conflict of Interest

All of the authors (C. Meydan, N. Goldstein, E. Weiss-Shwartz, D. Lederfine, D. Goitein, M. Rubin, H. Spivak) declare no conflict of interest associated with this study.

Ethics

Informed consent was obtained from all individual participants included in the study.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Department of Surgery C, Chaim Sheba Medical Center, 2 Sheba Rd., Tel Hashomer, 56261, Israel

    Chanan Meydan, David Goitein, Moshe Rubin & Hadar Spivak

  2. Felsentein Medical Research Center, Rabin Medical Center, Petah Tikva, Israel

    Nir Goldstein, Efrat Weiss-Shwartz, Doron Lederfine & Moshe Rubin

  3. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Chanan Meydan, Nir Goldstein, Efrat Weiss-Shwartz, Doron Lederfine, David Goitein, Moshe Rubin & Hadar Spivak

Authors
  1. Chanan Meydan
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  2. Nir Goldstein
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  3. Efrat Weiss-Shwartz
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  4. Doron Lederfine
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  5. David Goitein
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  6. Moshe Rubin
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  7. Hadar Spivak
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Corresponding author

Correspondence to Moshe Rubin.

Additional information

This work was performed in partial fulfillment of the requirements for a M.Sc. degree of the students Nir Goldenstein and Efrat Weiss-Shwartz, Sackler Faculty of Medicine, Tel Aviv University, Israel.

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Meydan, C., Goldstein, N., Weiss-Shwartz, E. et al. Immediate Metabolic Response Following Sleeve Gastrectomy in Obese Diabetics. OBES SURG 25, 2023–2029 (2015). https://doi.org/10.1007/s11695-015-1669-8

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  • DOI: https://doi.org/10.1007/s11695-015-1669-8

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