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Weight Regain and Diabetes Evolution After Sleeve Gastrectomy: a Cohort Study with over 5 Years of Follow-Up

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Abstract

Background

A number of meta-analyses have demonstrated the effectiveness of bariatric surgery in improving morbid obesity and its associated co-morbidities. The aim of the study was to evaluate at long term a cohort of obese patients with type 2 diabetes (T2DM) submitted to laparoscopic sleeve gastrectomy (LSG) analyzing the incidence of weight regain (WR) and the impact of the WR on T2DM evolution.

Methods

Seventy-eight morbid obese patients (54 females) with T2DM, aged 49.6 ± 8.7 years, weight 121.1 ± 24.4 kg, BMI 44.1 ± 7.2 kg/m2, underwent primary LSG. The trend over time of T2DM after LSG was analyzed in the different groups, subdivided on the basis of the absence or presence of WR and of its different degrees: no regain (NR), mild regain (MR), and severe regain (SR) groups.

Results

In the NR group, 54% show complete remission, 46% persistence, and no case of diabetes relapse; in the MR group, 59% show complete remission, 36% persistence, and 5% relapse; in the SR group, 61% show complete remission, 22% persistence, and 17% relapse. A statistically significant difference concerns the preoperative values of fasting glucose, glycosylated hemoglobin, and duration of diabetes, major in the group with diabetes relapse (respectively, p = 0.002, p = 0.001, and p < 0.0001).

Conclusions

The results of this study showed no significant difference regarding the trend of diabetes remission comparing the “no regain,” “mild regain,” and “severe regain” groups and confirmed the importance of the duration of the illness and an early intervention towards surgical therapy.

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Authors and Affiliations

  1. Department of Medico-surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy

    D Capoccia, F Coccia, G Guarisco, M Testa & F Leonetti

  2. Division of General Surgery & Bariatric Center of Excellence IFSO EU, Latina, Italy

    A Guida & G Silecchia

Authors
  1. D Capoccia
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  2. A Guida
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  3. F Coccia
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  4. G Guarisco
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  5. M Testa
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  6. F Leonetti
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  7. G Silecchia
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Correspondence to D Capoccia.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Informed consent was obtained from all patients for being included in the study.

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Capoccia, D., Guida, A., Coccia, F. et al. Weight Regain and Diabetes Evolution After Sleeve Gastrectomy: a Cohort Study with over 5 Years of Follow-Up. OBES SURG 30, 1046–1051 (2020). https://doi.org/10.1007/s11695-019-04350-0

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  • DOI: https://doi.org/10.1007/s11695-019-04350-0

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