Jindal Rohit, Gupta Mayank, Ahuja Ashish, Nain Prabhdeep Singh, Sharma Pranjl, Aggarwal Aayushi
Department of General Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Niger J Surg. 2020 Jan-Jun;26(1):66-71. doi: 10.4103/njs.NJS_9_19. Epub 2020 Feb 10.
An exponential rise in the prevalence of obesity and the associated type 2 diabetes mellitus (T2DM) has led to an explosion in the field of bariatric surgery worldwide. It has been proposed that laparoscopic sleeve gastrectomy (LSG) not only results in excess weight loss (EWL) but also leads to excellent glycemic control.
However, not every patient benefits from the bariatric surgery. Furthermore, bariatric surgery is currently indicated based on body mass index (BMI), but BMI solely does not predict diabetes remission after the surgery. We aimed to study the outcome of LSG on the diabetic status and the factors predicting the disease remission.
This prospective study was conducted on 104 obese patients having T2DM who underwent LSG. Following surgery, the clinical outcome on weight loss, BMI, and glycemic control was studied for 6 months. Various positive and negative predictors of diabetic remission after the surgery were also determined. Student's -test and Chi-square tests were applied.
LSG resulted in significant weight loss ( < 0.05); the percentage of EWL was 60.75 ± 6.30 at 6 months. Furthermore, surgery resulted in 78.9% remission of diabetes with fasting blood glucose and glycated hemoglobin values at 6 months being 121.13 ± 15.25 mg/dl and 6.19% ± 0.31%, respectively. Younger and heavier patients, those with lesser disease severity and shorter duration had better chances of disease remission. Gender had no correlation with disease remission.
LSG is a successful treatment option for T2DM and is more beneficial if offered, not as a last option, but to younger, obese patients with mild disease severity and shorter disease duration after the failure of medical treatment.
肥胖症及相关的2型糖尿病（T2DM）患病率呈指数级上升，导致全球范围内减肥手术领域迅速发展。有人提出，腹腔镜袖状胃切除术（LSG）不仅能实现体重减轻，还能实现出色的血糖控制。
然而，并非每位患者都能从减肥手术中获益。此外，减肥手术目前是根据体重指数（BMI）来确定适应症的，但仅BMI并不能预测术后糖尿病的缓解情况。我们旨在研究LSG对糖尿病状态的影响以及预测疾病缓解的因素。
本前瞻性研究针对104例患有T2DM的肥胖患者进行了LSG手术。术后，对体重减轻、BMI和血糖控制的临床结果进行了6个月的研究。还确定了术后糖尿病缓解的各种正性和负性预测因素。采用了学生t检验和卡方检验。
LSG导致显著体重减轻（P<0.05）；6个月时体重减轻百分比为60.75±6.30。此外，手术使78.9%的糖尿病得到缓解，6个月时空腹血糖和糖化血红蛋白值分别为121.13±15.25mg/dl和6.19%±0.31%。年龄较轻、体重较重、疾病严重程度较轻且病程较短的患者疾病缓解的机会更大。性别与疾病缓解无关。
LSG是治疗T2DM的一种成功选择，若将其提供给年轻、肥胖、疾病严重程度较轻且病程较短的患者，而非作为最后的选择，而是在药物治疗失败后使用，会更有益。
