Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy

Objective

Obesity is one of the major health challenges throughout the world. The association between obesity and diabetes is well established because 90% of patients with type 2 diabetes mellitus (T2DM) show excess body weight. The aim of the study was to evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on morbid obesity and type 2 diabetes (T2DM) in the long-term follow-up.

Methods

One hundred ninety-five obese patients, 78 with T2DM, were evaluated before and after LSG up to 10 years, to identify complete diabetes remission (FPG?

Results

Before surgery, body weight and BMI were 123?±?21 kg and 44.6?±?6.8 kg/m² respectively; at a mean follow-up of 7 years (range 4–10), body weight was 104.9?±?18 kg and BMI 37?±?6 kg/m². Minimum weight was reached after 2 years. T2DM remission was observed in 66, 57, and 52% at short (?5 years) follow-up respectively. Furthermore, 45.2% maintained complete remission for at least 5 years and about 36% showed a persistent but improved diabetes. None of the patients cured from diabetes had a duration disease greater than 8 years and a glycemic control requiring insulin. The prevalence of hypertension and dyslipidemia significantly decreased from 49 to 35% and from 51 to 40% respectively.

Conclusions

LSG significantly improves body weight, diabetes, hypertension, and dyslipidemia in long-term follow-up.