Department of Gastrointestinal Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People's Republic of China.
Center for Obesity and Metabolic Surgery, Huashan Hospital of Fudan University, Shanghai, 200040, China.
Obes Surg. 2024 May;34(5):1491-1495. doi: 10.1007/s11695-024-07112-9. Epub 2024 Feb 26.
Bariatric and metabolic surgery is recommended for Asian patients with type 2 diabetes mellitus (T2DM) and BMI ≥ 27.5 kg/m. However, mid to long-term ·evidence is still lacking.
Patients' data that underwent laparoscopic sleeve gastrectomy (SG) as the primary surgery at the Affiliated Hospital of Xuzhou Medical University were analyzed. Patients with T2DM diagnosed with either fasting blood glucose (FBG) ≥ 7.0 mmol/L or glycosylated hemoglobin (HbA1c) level ≥ 7.0% and 27.5 ≤ BMI ≤ 30 kg/m were included.
24 patients (7 male and 17 female) were included in this study. With a mean follow-up duration of 4.5 ± 1.1 years, the mean percentage of total weight loss (%TWL) was 14.4 ± 6.7%. Postoperatively, nine patients (37%) still required oral anti-diabetic medications, while no patients used insulin. FBG and HbA1c levels declined to 6.3 ± 1.5 mmol/L and 6.0 ± 1.0%, respectively. Fifteen patients (63%) were with HbA1c levels < 7% and without medication requirements, five patients (21%) were with HbA1c levels < 7% with the help of oral anti-diabetic medication, and four patients (16%) were with HbA1c levels > 7% with the help of oral anti-diabetic medication.
Our study provides further evidence that SG could result in both T2DM improvement and remission in patients with BMI ≤ 30 kg/m. Longer follow-up duration and larger sample will be needed in the future.
对于 BMI≥27.5kg/m² 的 2 型糖尿病（T2DM）亚洲患者，建议进行减重与代谢手术。然而，目前仍缺乏中、长期证据。
分析在徐州医科大学附属医院接受腹腔镜袖状胃切除术（SG）作为初始手术的患者数据。将 T2DM 患者纳入研究，诊断标准为空腹血糖（FBG）≥7.0mmol/L 或糖化血红蛋白（HbA1c）水平≥7.0%，同时 BMI 为 27.5kg/m²≤BMI≤30kg/m²。
本研究共纳入 24 例患者（7 例男性，17 例女性），平均随访时间为 4.5±1.1 年，总体重减轻百分比（%TWL）的平均值为 14.4±6.7%。术后，9 例（37%）患者仍需服用口服降糖药，无患者使用胰岛素。FBG 和 HbA1c 水平分别降至 6.3±1.5mmol/L 和 6.0±1.0%。15 例（63%）患者的 HbA1c 水平＜7%且无需药物治疗，5 例（21%）患者的 HbA1c 水平＜7%，需要口服降糖药治疗，4 例（16%）患者的 HbA1c 水平＞7%，需要口服降糖药治疗。
本研究进一步证实，对于 BMI≤30kg/m² 的 T2DM 患者，SG 可改善并缓解 T2DM。未来需要更长的随访时间和更大的样本量。
