Highlights
- •Bariatric surgery is safe and effective in diabetic patients.
- •Every unit of increased BMI improves the chance of diabetes remission by 16%.
- •Increased levels of HbA1C reduce the chance of diabetes remission by 0.9%.
- •Laparoscopic sleeve gastrectomy improves commodities in diabetic patients.
Abstract
Background and aim
Obesity is a global concern with several health-related complications. Bariatric surgeries
are major treatment options in patients with obesity and other comorbidities. This
study aims to investigate the effects of sleeve gastrectomy on metabolic indexes,
hyperechogenic liver changes, inflammatory state, diabetes, and other obesity-related
comorbidities remission after the sleeve gastrectomy.
Methods
This prospective study was conducted on patients with obesity candidates for laparoscopic
sleeve gastrectomy. Patients were followed for one year after the surgery. Comorbidities,
metabolic and inflammatory parameters were assessed before and one- year after the
surgery.
Results
137 patients (16 males, 44 in the DM group) underwent sleeve gastrectomy. One year
after the study, obesity-related comorbidities improved significantly; diabetes had
complete remission in 22.7% and partial remission in 63.6% of patients. Hyper-cholesterolemia,
hyper-triglyceridemia, and hyper-uricemia also improved in 45.6%, 91.2%, and 69% of
the patients. Metabolic syndrome indexes improved in 17.5% of the patients. Also,
the prevalence of hyperechogenic changes in the liver has declined from 21% before
the surgery to 1.5% after that. Based on logistic regression analysis, increased levels
of HbA1C reduced the chance of diabetes remission by 0.9%. In comparison, every unit
of increased BMI before the surgery improved the case of diabetes remission by 16%.
Conclusion
Laparoscopic sleeve gastrectomy is a safe and effective treatment option in patients
with obesity and diabetes. Laparoscopic sleeve gastrectomy alleviates BMI and insulin
resistance and effectively improves other obesity-related comorbidities such as Hypercholesterolemia,
hyper-triglyceridemia, hyper-uricemia, and hyperechogenic changes of the liver. HbA1C
and BMI before the surgery are notable predictors of diabetes remission within the
first year after the surgery.
Keywords
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Article info
Publication history
Published online: March 07, 2023
Accepted:
March 5,
2023
Received in revised form:
February 21,
2023
Received:
August 27,
2022
Identification
Copyright
© 2023 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
