Obesity Surgery

, Volume 17, Issue 8, pp 1069–1074 | Cite as

Short-term Effects of Sleeve Gastrectomy on Type 2 Diabetes Mellitus in Severely Obese Subjects

  • J. Vidal
  • A. Ibarzabal
  • J. Nicolau
  • M. Vidov
  • S. Delgado
  • G. Martinez
  • J. Balust
  • R. Morinigo
  • A. Lacy
Research Articles

Background

Data on the effectiveness of sleeve gastrectomy (SG) in improving or resolving type 2 diabetes mellitus (T2DM) are scarce.

Methods

A 4-month prospective study was conducted on the changes in glucose homeostasis in 35 severely obese T2DM subjects undergoing laparoscopic SG (LSG) and 50 subjects undergoing laparoscopic Roux-en-Y gastric bypass (LRYGBP), matched for DM duration, type of DM treatment, and glycemic control.

Results

At 4-months after surgery, LSG and LRYGBP operated subjects lost a similar amount of weight (respectively, 20.6 ± 0.7% and 21.0 ± 0.6%). T2DM had resolved respectively in 51.4% and 62.0% of the LSG and LRYGBP operated subjects (P = 0.332). A shorter preoperative DM duration (P < 0.05), a preoperative DM treatment not including pharmacological agents, and a better pre-surgical fasting plasma glucose (P < 0.01) or HbA1c (P < 0.01), were significantly associated with a better type 2 DM outcome in both surgical groups.

Conclusions

Our data show that LSG and LRYGBP result in a similar rate of type 2 DM resolution at 4-months after surgery. Moreover, our data suggest that mechanisms beyond weight loss may be implicated in DM resolution following LSG and LRYGBP.

Key words

Morbid obesity type 2 diabetes mellitus sleeve gastrectomy gastric bypass insulin sensitivity weight loss 

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References

  1. 1.
    Buchwald H, Avidor Y, Brawnwald E et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292: 1724–37.PubMedCrossRefGoogle Scholar
  2. 2.
    Cummings DE, Overduin J, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab 2004; 89: 2608–15.PubMedCrossRefGoogle Scholar
  3. 3.
    Dixon JB, O’Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care 2002; 25: 358–63.PubMedCrossRefGoogle Scholar
  4. 4.
    Frezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today 2007; 37: 275–81.PubMedCrossRefGoogle Scholar
  5. 5.
    Regan JP, Inabnet WB, Gagner M et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003; 13: 861–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Baltasar A, Serra C, Perez N et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg 2005; 15: 1124–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 2006; 16: 1450–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg 2005; 15: 1469–75.PubMedCrossRefGoogle Scholar
  9. 9.
    Langer FB, Reza Hoda MA, Bohdjalian A et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005; 15: 1024–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Melissas J, Koukouraki S, Askoxylakis J et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg 2007; 17: 57–62.PubMedCrossRefGoogle Scholar
  11. 11.
    Cottam D, Qureshi FG, Mattar SG et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 2006; 20: 859–63.PubMedCrossRefGoogle Scholar
  12. 12.
    Schauer PR, Burguera B, Ikramuddin S et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg 2003; 238: 467–84.PubMedGoogle Scholar
  13. 13.
    Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diab Care 2003; 26: S5–S20.CrossRefGoogle Scholar
  14. 14.
    Vidal J, Morinigo R, Codoceo VH et al. The importance of diagnostic criteria in the association between the metabolic syndrome and cardiovascular disease in obese subjects. Int J Obes 2005; 29: 668–74.CrossRefGoogle Scholar
  15. 15.
    Grundy SM, Cleeman JI, Daniels SR et al. American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 25: 2735–52.CrossRefGoogle Scholar
  16. 16.
    Morínigo R, Casamitjana R, Moizé V et al. Shortterm effects of gastric bypass surgery on circulating ghrelin levels. Obes Res 2004; 12: 1108–16.PubMedCrossRefGoogle Scholar
  17. 17.
    Silecchia G, Boru C, Pecchia A et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on comorbidities in super-obese high-risk patients. Obes Surg. 2006; 16: 1138–44.PubMedCrossRefGoogle Scholar
  18. 18.
    Torquati A, Lutfi R, Abumrad N et al. Is Roux-en-Y gastric bypass surgery the most effective treatment for type 2 diabetes mellitus in morbidly obese patients? J Gastrointest Surg 2005; 9: 1112–18.PubMedCrossRefGoogle Scholar
  19. 19.
    Dixon JB, Pories WJ, O’Brien PE et al. Surgery as an effective early intervention for diabesity: why the reluctance? Diabetes Care 2005; 28: 472–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • J. Vidal
    • 1
    • 2
  • A. Ibarzabal
    • 1
  • J. Nicolau
    • 1
  • M. Vidov
    • 1
  • S. Delgado
    • 1
  • G. Martinez
    • 1
  • J. Balust
    • 1
  • R. Morinigo
    • 1
  • A. Lacy
    • 1
  1. 1.Obesity UnitHospital Clinic UniversitariBarcelonaSpain
  2. 2.Obesity UnitHospital Clínic UniversitariBarcelonaSpain

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