Impact of sleeve gastrectomy on abnormalities in carbohydrate tolerance in obese adult

Abstract

Introduction: Facing the repeated failures of the medical management of obesity, bariatric surgery offers a promising therapeutic option in terms of achieving weight loss and metabolic benefits.

Aim: To evaluate the impact of sleeve gastrectomy on the carbohydrate profile of a group of obese subjects.

Methods: It is a prospective study including 40 obese patients (7 Men and 33 Women) who underwent sleeve gastrectomy between 2016 and 2018. Clinical and biological parameters were collected before the intervention, at six months and one year after. Insulin resistance was defined by a HOMA-IR index ≥2.4. Remission of diabetes was determined using the American Society for Metabolic and Bariatric Surgery's (ASMBS) criteria.

Results: The mean patients' age was 34.65 ± 8.17 years. The mean body mass index (BMI) was 50.23 ± 8.3 kg/m². One year after sleeve gastrectomy, the frequency of insulin resistance, decreased from 89% to 4% (p<0.05). The evolution of carbohydrate tolerance abnormalities was marked by the diabetes and prediabetes remission in 75% and 100% of cases, respectively. The mean excess weight loss was 55.8% at 12 months.

Conclusion: These results have expanded our knowledge of the short-term sleeve gastrectomy's effectiveness on the carbohydrate profile of obese subjects. However, it would be interesting to check the durability of this metabolic benefit in the medium and long term.

Figure 1. Variation de l'indice de HOMA-IR selon la perte de l'excès pondéral à six moispostopératoire.

Figure 2. Fréquences de l'insulinorésistance, du prédiabète et du diabète avant et après lasleeve gastrectomie.

• p (T0 – T6mois) < 0,05 ; ** p (T0 – T12mois) < 0,05