Weight Loss and Diabetes Control Following Laparoscopic Sleeve Gastrectomy

Background: Data following laparoscopic sleeve gastrectomy (LSG) for type 2 diabetes mellitus obese patients are extremely variable and we herein present our results. Methods: 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. Results: 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/m(2) 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. Conclusion: Diabetic obese patients with BMI >40 kg/m(2), 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.