Laparoscopic sleeve gastrectomy for diabetics - 5-year outcomes.
OBJECTIVE
Although the laparoscopic sleeve gastrectomy (SG) is increasingly performed for morbid obesity, gastric bypass is still considered by many to be the gold standard procedure for obese diabetic patients. The aim of this study was to assess the long-term results of SG in morbidly obese patients with type 2 diabetes.


METHODS
Diabetic patients who underwent SG at a single center between 2009 and 2011 were included. Outcomes assessed included postoperative complications, weight loss, and resolution or improvement in co-morbidities with an emphasis on diabetes, including glycated hemoglobin (HbA1C) and medication status.


RESULTS
Fifty-one diabetic patients underwent SG, 35 females and 16 males, with a collective mean age of 49 years and a mean body mass index of 43.2 kg/m2. On average, patients had had diabetes for 5.4 ± 7.3 years before surgery. Mean HbA1C and fasting glucose levels were 7.9 ± 1.6% and 166.9 ± 63 mg/dL, respectively. Eleven patients (22%) were insulin dependent at the time of surgery. Average body mass index at a mean follow-up of 5 years after surgery was 34.4 ± 5.8 kg/m2, with an average HbA1C of 6.6 ± 1% and an average fasting glucose of 123 ± 60 mg/dL. Only 3 patients remained insulin dependent.


CONCLUSION
SG offers retainable weight loss results, accompanied by longstanding resolution or improvement of diabetes. Prospective, randomized controlled studies are warranted to better compare long-term outcomes between SG and gastric bypass.
['Lessing|Yonatan|Y|', 'Pencovich|Niv|N|', 'Lahat|Guy|G|', 'Klausner|Joseph M|JM|', 'Abu-Abeid|Subhi|S|', 'Meron Eldar|Shai|S|']
D000328:Adult D050110:Bariatric Surgery D001786:Blood Glucose D015992:Body Mass Index D003924:Diabetes Mellitus, Type 2 D005260:Female D005743:Gastrectomy D006442:Glycated Hemoglobin A D006801:Humans D006949:Hyperlipidemias D006973:Hypertension D010535:Laparoscopy D007902:Length of Stay D008297:Male D008875:Middle Aged D017202:Myocardial Ischemia D009767:Obesity, Morbid D012086:Reoperation D012189:Retrospective Studies D016896:Treatment Outcome D015431:Weight Loss
Laparoscopic sleeve gastrectomy Diabetes Obesity Bariatric surgery Metabolic syndrome