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The Effects of Laparoscopic Sleeve Gastrectomy (LSG) on Obesity-Related Type 2 Diabetes Mellitus: a Prospective Observational Study from a Single Center

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Abstract

Purpose

The objective of the study is to evaluate the effects of laparoscopic sleeve gastrectomy (LSG) on mid- to long-term regulation of blood glucose in patients with obesity and type 2 diabetes mellitus (T2DM)

Materials and Methods

In this prospective and observational single-center study, a total of 234 patients with obesity and a diagnosis of T2DM who underwent LSG between 2015 and 2020 were evaluated. The demographics and laboratory data, consisting of body mass index (BMI), glycosylated hemoglobin (HbA1c%), and fasting plasma glucose (FPG) and total weight loss (TWL%), were compared preoperative and postoperative at 12th and 18th months and annual follow-up for seven consecutive years.

Results

The mean age of 234 patients (female(n)/male(n):191/43) included in the study was 44.69±9.72 years, while the preoperative mean BMI, FPG, and HbA1c values were 47.9±6.82, 132.09±42.84 mg/dl, and 7.02±1.35% respectively. The mean rate of weight loss (TWL%), which was 34.7 in the 18 months, decreased to 23.15 in the 7th year. While the HbA1c % value was 7.02±1.35 in the preoperative, it was found 5.71 ± 0.75 (p<0.001) and 6.30 ± 1.77 (p<0.05) at the 18th month and 7th year after the operation, respectively. While the DM remission rate was 71.1% at the postoperative 18th month, it was 45.4% at the 7th year, despite the patients regaining weight in the follow-ups.

Conclusions

Our study revealed that LSG resulted in high remission rates that continued for 7 years after the surgery, although sustained improvement or remission of diabetes despite some weight regain after the first 18 months.

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Acknowledgements

Seda Sancak, as principal investigator, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Department of Internal Medicine, Endocrinology and Metabolism Disorders, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Atasehir, 34752, Istanbul, Turkey

    Özgen Çeler & Seda Sancak

  2. Department of Internal Medicine, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Atasehir, 34752, Istanbul, Turkey

    Hatice Cansu Er, Elif Çırak, Ali Özdemir & Yaşar Sertbaş

  3. General Surgery Clinic, Fatih Sultan Mehmet Education and Research Hospital, University of Health Sciences, Atasehir, 34752, Istanbul, Turkey

    Aziz Bora Karip, Nuriye Esen Bulut, Mehmet Timuçin Aydın, Hasan Altun & Kemal Memişoğlu

  4. Interbariatrics Clinic, Şişli, 34365, Istanbul, Turkey

    Hasan Altun

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  1. Özgen Çeler
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Correspondence to Özgen Çeler.

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Ethical Approval

To conduct the study, institutional review board approval was obtained. The study was carried out in accordance with the Declaration of Helsinki (2013) of the World Medical Association. 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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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key Points:

• Obesity and diabetes mellitus are a global health problem.

• Metabolic surgery may be an option for non-responsive diabetic obese patients.

• Metabolic surgery in diabetic obese patients aids weight loss and metabolic control.

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Çeler, Ö., Er, H.C., Sancak, S. et al. The Effects of Laparoscopic Sleeve Gastrectomy (LSG) on Obesity-Related Type 2 Diabetes Mellitus: a Prospective Observational Study from a Single Center. OBES SURG 33, 2695–2701 (2023). https://doi.org/10.1007/s11695-023-06707-y

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