Laparoscopic Sleeve Gastrectomy for Type 2 Diabetes Mellitus: Long-Term Result and Recurrence of Diabetes
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ORIGINAL CONTRIBUTIONS
Laparoscopic Sleeve Gastrectomy for Type 2 Diabetes Mellitus: Long-Term Result and Recurrence of Diabetes Ming-Hsien Lee 1 & Owaid M. Almalki 2,3 & Wei-Jei Lee 3
&
Shu-Chun Chen 3 & Jung-Chien Chen 3 & Chun-Chi Wu 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Laparoscopic sleeve gastrectomy (LSG) is becoming a primary bariatric/metabolic surgical procedure for treating obesity and related type 2 diabetes mellitus (T2D). This study presents the long-term outcome of LSG about the remission and recurrence of T2D. Methods A total of 59 obese patients (38 women and 21 male) with T2D (mean body mass index [BMI] 37.6 ± 5.1 kg/m2) who underwent LSG from 2006 to 2014 with complete 5 years followed up were selected for present study. The remission of T2D was evaluated in stratified groups using the ABCD scoring system which is composed of the age, BMI, C-peptide, and duration of T2D. Results The weight loss at 5 years after surgery was 23.5% and the mean BMI decreased to 27.7 ± 4.5 kg/m2. The mean HbA1c decreased from 8.1 to 6.1% at 5 years. The 1-year and 5-year complete remission rate (HbA1c < 6.0%) was 62.7% and 42.4%. Thirteen patients (35.1%) out of 37 patients who had their T2D remission at 1 year had their T2D recurrent at 5 years. Patients with ABCD score higher than 5 had a higher long-term T2D remission rate and less recurrence of their T2D than those with ABCD score less than 5. The remission and recurrence of T2D after were associated with a weight loss more than 20%. Conclusion LSG is an effective procedure for T2D treatment but a significant portion of patients had their T2D recurrence at long-term. LSG is better recommended to patients with their ABCD score ≥ 5 and dedication to maintain a good weight loss is important. Keywords Type 2 DM . Sleeve gastrectomy . Recurrence . ABCD score
Introduction Type 2 diabetes mellitus (T2D) is one of the major global health threats of our time. The global prevalence of T2D was estimated to rise to 415 million by 2025 [1]. Recently, bariatric/metabolic surgery has been proven to be very successful in treating not just morbid obesity but also obese associated T2D [2–4]. Among all the bariatric/metabolic procedures, laparoscopic sleeve gastrectomy (LSG) has been
* Wei-Jei Lee [email protected] 1
Metabolic & bariatric surgical department, Buddhist Tzu Chi Medical Foundation, Taichung Tzu Chi Hospital, Taichung City, Taiwan
2
Department of Surgery, College of Medicine, Taif University, Taif, Saudi Arabia
3
Department of Surgery, Min-Sheng General Hospital, 168, Ching-Kuo Rd, Taoyuan, Taiwan, Republic of China
gaining popularity and was the most commonly performed bariatric/metabolic surgery worldwide [5, 6] Recently, LSG has been proven to be effective and safe for the treatment of T2D [7–9]. Some recommendation has also been given for selecting LSG as a metabolic procedure for obese T2D patients [10, 11]. Many reports also promoted LSG as a metabolic procedure for the treatment of T2D
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