bariatric surgery

Can Sleeve Gastrectomy Resolve Type 2 Diabetes?

Laparoscopic sleeve gastrectomy (LSG) starts resolving diabetes within the first 3 days after surgery, according to a new review. Results also showed that the majority of diabetes cases were resolved after 3 years after surgery.

To evaluate the time-related effects of weight loss, ghrelin levels, and glucacon-like peptide-1 (GLP-1) plasma concentrations after LSG, the researchers investigated 91 patients who had undergone LSG at a hospital in Italy.

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Follow-up assessments took place on postoperative day 3 and at 6, 12, 24, and 36 months after surgery, at which times, the following data were collected:

  • Insulin secretion, insulin resistance, plasma glucose level, and percentage glycated hemoglobin via an oral glucose tolerance test;
  • Weight loss measurements;
  • Ghrelin levels; and
  • GLP-1 levels.

After analyzing the data, the researchers found that the resolution rates of type 2 diabetes were 9.4% at postoperative day 3, 42.3% at 6 months, 71.8% at 12 months, 81.2% at 24 months, and 91.8% after 36 months.

In addition, they found that ghrelin plasma concentrations had significantly decreased and GLP-1 plasma concentrations had significantly increased after LSG.

“LSG may affect glucose homeostasis by 2 different time-related modes: a first step in which the hormonal changes play a predominant role in glucose homeostasis and a second step in which the percentage excess weight loss determines the metabolic results,” the researchers concluded.

—Amanda Balbi

Reference:

Sista F, Abruzzese V, Clementi M, Guadagni S, Montana L, Carandina S. Resolution of type 2 diabetes after sleeve gastrectomy: a 2-step hypothesis. 2018;14(3):284-290. https://doi.org/10.1016/j.soard.2017.12.009.