Five-year long-term clinical outcome after bariatric metabolic surgery: A multi-ethnic Asian population in Singapore

Diabetes Obes Metab. 2018 Jul;20(7):1762-1765. doi: 10.1111/dom.13263. Epub 2018 Mar 25.

Abstract

Bariatric surgery is an effective treatment for morbid obesity and its metabolic related comorbidities; type 2 diabetes, hypertension and hyperlipidaemia.1 However, the literature is scarce regarding the long-term outcome after bariatric surgery, especially among multi-ethnic Asian populations. Considering the growing number of bariatric metabolic surgeries in Asia, we have attempted to provide a regional perspective on 5-year long-term clinical outcomes post bariatric surgery in Singapore. Between 2010 and 2016, all bariatric operative cases were included, and these comprised: laparoscopic sleeve gastrectomy (LSG), 393; laparoscopic Roux-En-Y gastric bypass (RYGB), 125; laparoscopic mini-gastric bypass (MGB), 43. The primary outcome measure was the percentage of excess weight loss (% EWL) at 6 months, 1, 2, 3, 4 and 5 years, with % remission of type 2 diabetes mellitus (T2DM) at 1 year following LSG (49.7%, 61.2%, 56.1%, 47.8%, 40.8% and 47.3%; 82.2%), RYGB (60.2%, 62.1%, 57.6%, 50.1%, 48.7% and 47.7%; 86.9%) and MGB (58%, 68.1%, 62.7%, 66.2%, 64.0%, 65.2%; 71.9%). In conclusion, MGB and RYGB showed the greatest % EWL at 5 years and are recommended for moderate T2DM. LSG is an effective bariatric operation with a high % EWL up to 2 years, and a high remission rate of mild T2DM. The remission rate of T2DM was equally high in all 3 surgical groups, independent of ethnic differences.

Keywords: bariatric metabolic surgery, diabetes, mini-gastric bypass, obesity, Roux-en-Y gastric bypass; sleeve gastrectomy; weight loss.

MeSH terms

  • Adult
  • Asian Continental Ancestry Group*
  • Bariatric Surgery*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Gastrectomy
  • Gastric Bypass
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Laparoscopy
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / surgery*
  • Remission Induction
  • Severity of Illness Index
  • Singapore
  • Treatment Outcome
  • Weight Loss

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human