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Five-Year Outcomes of Sleeve Gastrectomy in Patients with Class I Obesity and Type 2 Diabetes Mellitus

Abstract

Background

Several studies have reported short and medium-term outcomes of laparoscopic sleeve gastrectomy (LSG) in patients with class I obesity and type 2 diabetes mellitus (T2DM). However, literature on outcomes beyond three years is scarce. The present study discusses the 5-year results of a previously reported cohort of 20 patients with class I obesity and T2DM, who had undergone LSG between March 2012 and March 2015.

Materials and Methods

Patients were followed up in the bariatric clinic at yearly intervals as per institute protocol. Primary outcome was proportion of patients with a glycated haemoglobin (HbA1c) level of 6.5% or less, 5 years after LSG. Secondary outcomes were percentage total weight loss (%TWL), excess weight loss (EWL), weight regain and complications.

Results

Out of 20 patients, 9 (45%) were male and 11 (55%) were female. Mean age was 41.6 ± 9.5 years. Mean pre-operative weight and BMI were 94.8 ± 14.4 kg and 33.4 ± 1.2 kg/m2, respectively. Median duration of diabetes was 42 months. Mean pre-operative fasting plasma glucose (FPG) and HbA1c were 171.1 ± 56.8 mg/dL and 8.7 ± 1.6%, respectively. Of the 17 patients available for follow-up at 5 years, 9 (52.9%) achieved HbA1c < 6.5% without medication, while 7 (41.2%) patients had improvement of their glycaemic status. One patient had recurrence of diabetes after initial remission. Mean %TWL and %EWL were 18% and 65.1%, respectively.

Conclusion

Laparoscopic sleeve gastrectomy is a reasonable option as a metabolic procedure for patients with T2DM and class I obesity.

Graphical abstract

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Authors and Affiliations

Authors

Contributions

Devender Singh - Acquisition and analysis of data, drafting and final approval of manuscript.

Aditya Baksi - Design of work, interpretation of data, drafting and final approval of manuscript.

Prasanna Ramana - Acquisition of data, drafting and final approval of manuscript.

Vitish Singla - Analysis of data, drafting and final approval of manuscript.

Sandeep Aggarwal - Conception and design of work, critical revision and final approval of manuscript.

Corresponding author

Correspondence to Sandeep Aggarwal.

Ethics declarations

The study was undertaken after clearance from institutional ethical committee. There was no commission or omission of intervention for the study purpose, and all the interventions were done in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

A written informed consent was taken from each patient for the surgical procedure.

Conflict of Interest

The authors declare no competing interests.

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Key Points

• The positive impact of sleeve gastrectomy on glycaemic control in patients with class I obesity and type 2 diabetes is sustained at five years after surgery.

• Mean HbA1c decreased from 8.7% to 6.6% at five years after sleeve gastrectomy.

• More than 70% patients achieved HbA1c less than 6.5% at five years.

• More than half the patients were off anti-diabetic medication.

• All patients on insulin before surgery were off insulin at five years.

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Singh, D., Baksi, A., Ramana, P. et al. Five-Year Outcomes of Sleeve Gastrectomy in Patients with Class I Obesity and Type 2 Diabetes Mellitus. OBES SURG 32, 96–102 (2022). https://doi.org/10.1007/s11695-021-05718-x

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  • DOI: https://doi.org/10.1007/s11695-021-05718-x

Keywords

  • Bariatric surgery
  • Metabolic surgery
  • Non-severe obesity
  • Long-term outcomes
  • T2DM