Resolution of Diabetes Mellitus with Laparoscopic Sleeve Gastrectomy

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) is a proven intervention to induce weight loss. Its applications as a surgical procedure may extend beyond body weight control to the realm of metabolic therapy in chronic conditions such as diabetes mellitus (DM), which results from the dysregulation of blood glucose levels. Objective: The aim of this study is to evaluate the improvement and resolution of diabetes following sleeve gastrectomy at our facilities. Setting: Two affiliated non-profit surgery centers, United States Methods: Eighty-two adult diabetic patients were treated with sleeve gastrectomy. We conducted a single point analysis of our existing longitudinal data for that calendar year through a retrospective chart review. Statistical outcomes were determined for anthropometric data unique to patients with DM including prescribed medications, Hemoglobin A1C, excessive weight loss (EWL), and body mass index (BMI). Results: Time was a significant predictor of diabetic resolution after six months post-op in patients who originally presented with Type 1 DM and change in hemoglobin A1C values held a significant association to improvement of Type 1 diabetes. BMI and EWL displayed a positive correlation to resolution at all time points of interest. Conclusions: There are differences between the post-operative improvements in diabetic status following sleeve gastrectomy depending on the initial diagnosis of insulin-dependent or insulinindependent DM. Pathophysiological mechanism of a patient’s diabetic condition, specifically auto-immune destruction of pancreatic beta cells, may contribute to the variable metabolic response following sleeve gastrectomy.