An observational longitudinal study of the impact of sleeve gastrectomy on glycemic control in type 2 diabetes mellitus

Abstract

Background: Laparoscopic sleeve gastrectomy is increasingly being acknowledged as an effective independent bariatric procedure for obese persons with type 2 diabetes. Data on laparoscopic sleeve gastrectomy from India on this group of patients are limited. This study presents 12-month follow-up data of laparoscopic sleeve gastrectomy on obese Indian patients with type 2 diabetes.

Subjects and methods: In total, 43 obese patients with type 2 diabetes who received sleeve gastrectomy surgery in the Department of Bariatric Surgery, Medanta the Medicity, Gurgaon, India, were evaluated prospectively for a period of 1 year.

Results: Seven patients missed follow-up visits, and one patient died, leaving 35 patients who were analyzed. The mean glycated hemoglobin (HbA1c) levels at baseline and 12 months after surgery were 7.94±1.9% and 5.80±0.7%, respectively (P<0.001). Of these, 77.14% reached the primary end point of HbA1c level ≤6% without medication. HbA1c level at target (i.e., <7%) occurred in 91.4%. The mean body weight decreased from 122.08±23.32 kg to 83.43±15.12 kg at 12 months (P<0.001). The percentage of weight loss and percentage of excess weight loss at 12 months were 31.14±7.8% and 61.52±15%, respectively. Antidiabetes medication use decreased from 88.57% to 11.4%.

Conclusions: Laparoscopic sleeve surgery is a safe and effective treatment option among the obese Indian type 2 diabetes population with significant remission rates. Follow-up studies are necessary to assess the long-term durability of these results.