Analysis of quality of life in patients with clinically severe obesity and type 2 diabetes mellitus after laparoscopic sleeve gastrectomy - a 12-month prospective observational study

Introduction: Due to a short history of laparoscopic sleeve gastrectomy (LSG) as an independent bariatric procedure, we still lack studies providing analysis of the quality of life (QoL) in patients with type 2 diabetes mellitus (DM2). Aim: We aimed to assess the influence of LSG on QoL in obese patients with DM2. Material and methods: Prospective, observational study included patients with: morbid obesity, body mass index (BMI) >= 35 kg/m2 and <= 50 kg/m2, DM2 shorter than 10 years, qualified for LSG. Bariatric Analysis and Reporting Outcome System (BAROS) that included the Moorehead-Ardelt Quality of Life Questionnaire II (MA-QoLQII) score, and the SF-36 Health Survey (SF-36) questionnaire were used for repetitive assessment of QoL before LSG and after one and 12 months following surgery. Selected clinical and biochemical parameters were also repeatedly measured. Results: Thirty-three patients were included in the study (23 females). Patients' mean age was 45 +/- 10 years. BAROS significantly increased before LSG, one month, and one year after surgery (0.63 +/- 1.12, 2.94 +/- 1.90, and 4.97 +/- 2.08, respectively). The MA-QoLQII score significantly rose with an increase of excess body mass index loss (EBMIL) (P = 0.002) and remission of DM2 (P = 0.049), while inversely correlated with Homeostatic Model Assessment for Insulin Resistance index (HOMA-IR) (P = 0.003). Degenerative joint disease (P = 0.025) and average time of low glucose concentration in continuous glucose monitoring (CGM) (P = 0.005) had an inverse correlation with SF-36 Physical Component Summaries (PCS), standardized for cardiovascular comorbidity, EBMILand HOMA-IR (P = 0.839; P = 0.086; P = 0.571, respectively). EBMIL (P = 0.003), remission of DM2 (P < 0.001) had a positive correlation with Mental Component Summaries (MCS), while HOMA-IR (P < 0.001) and count of low glucose concentration events (P = 0.022) had an inverse correlation with MCS, while standardized for average glucose concentration in CGM after 12 months (P = 0.586). Discussion: Significant improvement in QoL was observed in patients with DM2 after LSG. Remission of DM2, higher EBMIL, lower HOMA-IR, fewer and shorter low glucose concentration events in CGM after 12 months were factors that increased selected QoL scores.