Laparoscopic Sleeve Gastrectomy for Type 2 Diabetes Mellitus: Long-Term Result and Recurrence of Diabetes

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is becoming a primary bariatric/metabolic surgical procedure for treating obesity and related type 2 diabetes mellitus (T2D). This study presents the long-term outcome of LSG about the remission and recurrence of T2D.

Methods

A total of 59 obese patients (38 women and 21 male) with T2D (mean body mass index [BMI] 37.6 ± 5.1 kg/m2) who underwent LSG from 2006 to 2014 with complete 5 years followed up were selected for present study. The remission of T2D was evaluated in stratified groups using the ABCD scoring system which is composed of the age, BMI, C-peptide, and duration of T2D.

Results

The weight loss at 5 years after surgery was 23.5% and the mean BMI decreased to 27.7 ± 4.5 kg/m2. The mean HbA1c decreased from 8.1 to 6.1% at 5 years. The 1-year and 5-year complete remission rate (HbA1c < 6.0%) was 62.7% and 42.4%. Thirteen patients (35.1%) out of 37 patients who had their T2D remission at 1 year had their T2D recurrent at 5 years. Patients with ABCD score higher than 5 had a higher long-term T2D remission rate and less recurrence of their T2D than those with ABCD score less than 5. The remission and recurrence of T2D after were associated with a weight loss more than 20%.

Conclusion

LSG is an effective procedure for T2D treatment but a significant portion of patients had their T2D recurrence at long-term. LSG is better recommended to patients with their ABCD score ≥ 5 and dedication to maintain a good weight loss is important.

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Correspondence to Wei-Jei Lee.

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No human or animal rights were violated in this study. This retrospective study did not require the participation of the subjects.

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Lee, MH., Almalki, O.M., Lee, WJ. et al. Laparoscopic Sleeve Gastrectomy for Type 2 Diabetes Mellitus: Long-Term Result and Recurrence of Diabetes. OBES SURG 30, 3669–3674 (2020). https://doi.org/10.1007/s11695-020-04737-4

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Keywords

  • Type 2 DM
  • Sleeve gastrectomy
  • Recurrence
  • ABCD score