Type 2 diabetes in obese patients with body mass index of 30–35 kg/m2 : sleeve gastrectomy versus medical treatment

• Published in: Surgery for obesity and related diseases Vol. 8; no. 1; pp. 20 - 24
• Main Authors: Abbatini, Francesca, M.D, Capoccia, Danila, M.D, Casella, Giovanni, M.D, Coccia, Federica, M.D, Leonetti, Frida, M.D, Basso, Nicola, M.D
• Format: Journal Article
• Language: English
• Published: United States 2012
• Subjects: Adult; Body Mass Index; Diabetes Mellitus, Type 2; Female; Gastrectomy - methods; Gastroenterology and Hepatology; Humans; Laparoscopy - methods; Male; Middle Aged; Obesity - surgery; Surgery; Treatment Outcome; Metabolic surgery; Diabetes; Sleeve gastrectomy
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2011.06.015

Abstract Background Type 2 diabetes mellitus (T2DM) and obesity are diseases of epidemic proportions. Long-term realistic weight loss by nonsurgical methods has a variable effect on glycemic control, and only a proportion of patients with T2DM have a worthwhile response. Laparoscopic sleeve gastrectomy (LSG) has been proposed as an advantageous bariatric procedure for patients with a lower body mass index (BMI). Our objective was to compare the effects of LSG and medical therapy on patients with T2DM and a BMI of <35 kg/m2. Methods A total of 18 nonmorbidly obese patients with T2DM, diagnosed according to the American Diabetes Association guidelines, were consecutively enrolled. Of these patients, 9 underwent LSG (group A) and 9 underwent conventional medical therapy (group B). The 2 groups were matched for BMI, glycated hemoglobin (HbA1c) and C-peptide levels, pretrial therapy type, and number of patients with a T2DM duration of >10 years. Results In group A, T2DM resolution was achieved in 8 (88.8%) of the 9 patients (T2DM duration 5.2 yr). Hypertension was controlled in all 8 of 9 patients. Dyslipidemia was corrected. In 1 patient, obstructive sleep apnea syndrome improved. In group B, all 9 patients continued to have T2DM and required hypertensive and hypolipemic therapies throughout the observation period. At baseline, 3 patients were affected by obstructive sleep apnea syndrome and remained affected 1 year later. Conclusion The results of the present study have confirmed the efficacy of LSG in the treatment of nonmorbidly obese T2DM patients, with a remission rate of 88.8% without undesirable excessive weight loss. The results in this group of patients add to those obtained by us in patients with a BMI >35 kg/m2.