OBESE PATIENTS WITH TYPE 2 DIABETES: OUTCOMES AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY

Background: Bariatric surgery is superior to medical treatment for type 2 diabetes mellitus (T2DM) control in obese patients. Reports in the literature have been mainly based on Roux-en-Y gastric bypass (RYGB) or adjustable gastric band. The aim of this study was to analyze mid- and long-term metabolic results after laparoscopic sleeve gastrectomy (LSG). Methods: Obese patients with T2DM undergoing LSG were included in this study. Selection criteria for T2DM remission were: post-operatory fasting glucose (FG) level <100 mg/dL, and hemoglobin A1c (HbA1c) Results: Between January 2009 and July 2016, 166 T2DM obese patients underwent LSG and completed >= 1 year follow-up. There were 101 women (60.8%; mean age 49.07 +/- 12.8 years). Initial body mass index (BMI) was 46.44 +/- 7.68 kg/m(2). Mean time since T2DM diagnosis was 5.95 years (1-28). Preoperative HbA1c was 7.53% +/- 0.97%. Before LSG, 75.3% (n = 125) were receiving oral hypoglycemic agents, and 13.25% (n = 22) insulin. Mean follow-up was 65 +/- 10 months. Complete T2DM remission was achieved in 78.3%, 76.2%, and 71.4% at 1, 3, and >= 5 years respectively; in the long term, 7.2% attained partial remission, 10% improved, and 11.4% experienced recurrence of the disease. Remission rate was significantly lower in patients under insulin therapy preoperatively, and in patients with T2DM diagnosed >= 5 years before consultation (P = .0004 and .0001, respectively). Conclusions: At mid- and long-term follow-up, T2DM control was satisfactory after LSG. Preoperative insulin therapy and T2DM duration >= 5 years were predictors of less favorable outcomes.