Short-term and mid-term control of type 2 diabetes mellitus by laparoscopic sleeve gastrectomy with ileal interposition

Abstract

Background: Standard surgical procedures used for the treatment of morbid obesity constitute optional treatments for type 2 diabetes mellitus (T2DM). The aim of the present study was to evaluate the short- and mid-term effects of laparoscopic sleeve gastrectomy (SG) with ileal interposition (II) in T2DM patients (n = 30).

Methods: The variables investigated were the feasibility of the procedure, remission/alleviation of the disease, morbidity, mortality, and weight loss. Patients were followed during a period of 6-18 months after surgery.

Results: The average time required for the surgical procedure was 181.47 ± 53.23 min, and the mean duration of postoperative hospital stay was 3.17 ± 0.79 days. There were no intraoperative complications, and none of the patients required conversion to open surgery. Postoperatively, all patients experienced a significant weight loss: i.e., the mean body mass index (BMI) values prior to and following surgery were significantly different (P = 0.0001). Postoperative levels of glycosylated hemoglobin, fasting glucose, and fructosamine were significantly reduced (P = 0.0001, 0.0001, and 0.0004, respectively) from those detected prior to surgery. Remission of T2DM was observed in 80% of the patients over the follow-up period, and these subjects no longer required treatment with hypoglycemic drugs or diet. The remaining 20% of patients presented significant improvement in their condition but needed an oral hypoglycemic medication.

Conclusions: Adequate glycemic control, adjustable weight loss, and absence of nutritional deficiencies were the main benefits offered by the surgical intervention. The results indicate that SG/II treatment could be a promising alternative for patients with T2DM.