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

Obes Surg. 2022 Jan;32(1):96-102. doi: 10.1007/s11695-021-05718-x. Epub 2021 Oct 20.

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.

Keywords: Bariatric surgery; Long-term outcomes; Metabolic surgery; Non-severe obesity; T2DM.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / surgery
  • Female
  • Gastrectomy / methods
  • Glycated Hemoglobin / metabolism
  • Humans
  • Laparoscopy* / methods
  • Male
  • Middle Aged
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss

Substances

  • Glycated Hemoglobin A