Magdalena Mizera1, Michał Wysocki1, Katarzyna Bartosiak2, Paula Franczak3, Hady Razak Hady4, Piotr Kalinowski5, Piotr Myśliwiec4, Michał Orłowski3, Rafał Paluszkiewicz5, Jerzy Piecuch6, Jacek Szeliga7, Maciej Walędziak2, Piotr Major1, Michał Pędziwiatr8. 1. 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 Street, Building H 3rd floor, 30-688, Kraków, Poland. 2. Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland. 3. Department of General and Oncological Surgery, Ceynowa Hospital, Wejherowo, Poland. 4. 1st Department of General and Endocrin Surgery, Medical University of Białystok, Białystok, Poland. 5. Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. 6. Department of General Surgery, Bariatric Surgery and Emergency Medicine Zabrze, Silesian Medical University, Katowice, Poland. 7. Department of General, Gastroenterological and Oncological Surgery CM, Nicolaus Copernicus University, Toruń, Poland. 8. 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 Street, Building H 3rd floor, 30-688, Kraków, Poland. michal.pedziwiatr@uj.edu.pl.
Abstract
PURPOSE: Bariatric surgery is no longer considered only as a weight loss surgery but also a way of treating obesity-related comorbidities such as type 2 diabetes mellitus (T2DM). Short-term T2DM remissions in patients undergoing laparoscopic sleeve gastrectomy (LSG) have been shown, but there are very few reports on the mid-term results. We aimed to assess the remission rate of T2DM in obese patients after LSG throughout 5-year follow-up. MATERIALS AND METHODOLOGY: We performed a retrospective multicenter cohort analysis of 240 patients who underwent LSG. We assessed the remission rate of T2DM 1 year and 5 years after surgery. RESULTS: Forty-six percent of patients achieved T2DM remission 5 years after LSG. The remission group had better weight loss results (median% of total weight loss 5 years after: 30.1% (22.9-37.0) vs 23.0% (13.7-30.2), p < 0.001) and were significantly younger than the no remission group (43 (38-52) vs 52 (44-58) years, p < 0.001). Duration of T2DM was significantly shorter (2 (1-5) vs 5 (3-10) years, p < 0.001) with less insulin requirement and less diabetes-related complications (7.2% vs 19.8%, p < 0.001) and significantly lower median DiaRem score (4.0 (IQR 2.0-6.0) vs 12.0 (IQR 5.0-16.0), p < 0.001). Preoperative body mass index (BMI) had no effect on remission. CONCLUSIONS: Our study suggests that diabetes remission after laparoscopic sleeve gastrectomy occurs frequently, and in the 5-year follow-up, it may remain at the level of 46%. We identified the age of patients, duration, and severity of T2DM as factors affecting mid-term diabetes remission. Nevertheless, further well-designed trials are needed to support our findings.
PURPOSE: Bariatric surgery is no longer considered only as a weight loss surgery but also a way of treating obesity-related comorbidities such as type 2 diabetes mellitus (T2DM). Short-term T2DM remissions in patients undergoing laparoscopic sleeve gastrectomy (LSG) have been shown, but there are very few reports on the mid-term results. We aimed to assess the remission rate of T2DM in obesepatients after LSG throughout 5-year follow-up. MATERIALS AND METHODOLOGY: We performed a retrospective multicenter cohort analysis of 240 patients who underwent LSG. We assessed the remission rate of T2DM 1 year and 5 years after surgery. RESULTS: Forty-six percent of patients achieved T2DM remission 5 years after LSG. The remission group had better weight loss results (median% of total weight loss 5 years after: 30.1% (22.9-37.0) vs 23.0% (13.7-30.2), p < 0.001) and were significantly younger than the no remission group (43 (38-52) vs 52 (44-58) years, p < 0.001). Duration of T2DM was significantly shorter (2 (1-5) vs 5 (3-10) years, p < 0.001) with less insulin requirement and less diabetes-related complications (7.2% vs 19.8%, p < 0.001) and significantly lower median DiaRem score (4.0 (IQR 2.0-6.0) vs 12.0 (IQR 5.0-16.0), p < 0.001). Preoperative body mass index (BMI) had no effect on remission. CONCLUSIONS: Our study suggests that diabetes remission after laparoscopic sleeve gastrectomy occurs frequently, and in the 5-year follow-up, it may remain at the level of 46%. We identified the age of patients, duration, and severity of T2DM as factors affecting mid-term diabetes remission. Nevertheless, further well-designed trials are needed to support our findings.
Entities:
Keywords:
Diabetes remission; Laparoscopic sleeve gastrectomy; Type 2 diabetes mellitus
Authors: Jaime Ruiz-Tovar; Miguel Angel Carbajo; Jose Maria Jimenez; Maria Jose Castro; Gilberto Gonzalez; Javier Ortiz-de-Solorzano; Lorea Zubiaga Journal: Surg Endosc Date: 2018-06-25 Impact factor: 4.584
Authors: Rinki Murphy; Michael G Clarke; Nicholas J Evennett; S John Robinson; M Lee Humphreys; Hisham Hammodat; Bronwen Jones; David D Kim; Richard Cutfield; Malcolm H Johnson; Lindsay D Plank; Michael W C Booth Journal: Obes Surg Date: 2018-02 Impact factor: 4.129
Authors: Richard Welbourn; Marianne Hollyman; Robin Kinsman; John Dixon; Ronald Liem; Johan Ottosson; Almino Ramos; Villy Våge; Salman Al-Sabah; Wendy Brown; Ricardo Cohen; Peter Walton; Jacques Himpens Journal: Obes Surg Date: 2018-11-12 Impact factor: 4.129
Authors: Yoriko Heianza; Dianjianyi Sun; Xiang Li; Joseph A DiDonato; George A Bray; Frank M Sacks; Lu Qi Journal: Gut Date: 2018-06-02 Impact factor: 23.059
Authors: Maciej Walędziak; Anna M Różańska-Walędziak; Piotr K Kowalewski; Michal R Janik; Jakub Brągoszewski; Krzysztof Paśnik; Grzegorz Bednarczyk; Grzegorz Wallner; Maciej Matłok Journal: Wideochir Inne Tech Maloinwazyjne Date: 2018-08-19 Impact factor: 1.195
Authors: Eyup Gemici; Osman Kones; Hakan Seyit; Ahmet Surek; Murat Cikot; Mehmet Abdussamet Bozkurt; Halil Alis Journal: Wideochir Inne Tech Maloinwazyjne Date: 2019-02-25 Impact factor: 1.195
Authors: Karolina Zawadzka; Krzysztof Więckowski; Tomasz Stefura; Piotr Major; Magdalena Szopa Journal: J Clin Med Date: 2022-04-05 Impact factor: 4.241
Authors: Kirstie M Herb Neff; Leslie M Schuh; Karen K Saules; David B Creel; Joseph J Stote; Kristen M Schuh; Margaret Inman Journal: J Clin Psychol Med Settings Date: 2021-07-29