Weight Loss and Diabetes Control Following Laparoscopic Sleeve Gastrectomy

Data following laparoscopic sleeve gastrectomy (LSG) for type 2 diabetes mellitus obese patients are extremely variable and we herein present our results. The data of 320 (90 diabetic) obese patients who had LSG were retrieved from prospectively collected database. Postoperative weight loss and glycemic control were evaluated during 24 months follow-up. Diabetic patients had a significantly higher percentage excess weight loss (%EWL) (60.21 ± 11 and 72.9 ± 13) than nondiabetics (53.4 ± 12 and 62.5 ± 29) at 12 and 24 months post LSG, respectively. Diabetic patients with body mass index (BMI) >40 kg/m² had significantly higher %EWL (64.17 ± 13 and 75.2 ± 16) than patients with BMI ≤40 at 12 and 24 months, respectively. The mean glycated hemoglobin and fasting blood glucose were 6.6% ± 1.4%, 6.1% ± 1.1%, 5.9% ± 1.2%, 5.8% ± 0.5%, and 110 ± 1.6 mg/dL, 106.7 ± 1.8 mg/dL, 99.2 ± 1.9 mg/dL, and 98.1 ± 1.2 mg/dL at 1, 6, 12, and 24 months, respectively. All patients had complete diabetes remission at 12 months, and this was maintained at 24 months. Diabetic obese patients with BMI >40 kg/m², had a better %EWL compared with nondiabetics and to diabetics with lower BMI. Diabetes remission started early at 1 month. At 12 months, all diabetics had complete diabetes remission and this was maintained at 24 months. Our results need to be validated in a larger study, which evaluates impact of gastrointestinal motility on diabetes control.