Type 2 Diabetes Remission 5 Years After Laparoscopic Sleeve Gastrectomy: Multicenter Cohort Study
Magdalena Mizera, Michał Wysocki, Katarzyna Bartosiak, Paula Franczak, Hady Razak Hady, Piotr Kalinowski, Piotr Myśliwiec, Michał Orłowski, Rafał Paluszkiewicz, Jerzy Piecuch, Jacek Szeliga, Maciej Wałędziak, Piotr Major, Michał Pędziwiatr
Abstract
PURPOSE: Bariatric surgery is no longer considered only as a weight loss surgery but also a way of treating obesity-related comorbidities such as type 2 diabetes mellitus (T2DM). Short-term T2DM remissions in patients undergoing laparoscopic sleeve gastrectomy (LSG) have been shown, but there are very few reports on the mid-term results. We aimed to assess the remission rate of T2DM in obese patients after LSG throughout 5-year follow-up. MATERIALS AND METHODOLOGY: We performed a retrospective multicenter cohort analysis of 240 patients who underwent LSG. We assessed the remission rate of T2DM 1 year and 5 years after surgery. RESULTS: Forty-six percent of patients achieved T2DM remission 5 years after LSG. The remission group had better weight loss results (median% of total weight loss 5 years after: 30.1% (22.9-37.0) vs 23.0% (13.7-30.2), p < 0.001) and were significantly younger than the no remission group (43 (38-52) vs 52 (44-58) years, p < 0.001). Duration of T2DM was significantly shorter (2 (1-5) vs 5 (3-10) years, p < 0.001) with less insulin requirement and less diabetes-related complications (7.2% vs 19.8%, p < 0.001) and significantly lower median DiaRem score (4.0 (IQR 2.0-6.0) vs 12.0 (IQR 5.0-16.0), p < 0.001). Preoperative body mass index (BMI) had no effect on remission. CONCLUSIONS: Our study suggests that diabetes remission after laparoscopic sleeve gastrectomy occurs frequently, and in the 5-year follow-up, it may remain at the level of 46%. We identified the age of patients, duration, and severity of T2DM as factors affecting mid-term diabetes remission. Nevertheless, further well-designed trials are needed to support our findings.