SS  Vol.4 No.12 A , December 2013
Amelioration of Diabetes Mellitus Type II after Sleeve Gastrectomy—Data on Nationwide Survey on Quality Assurance in Bariatric Surgery in Germany
Abstract

Introduction: Sleeve Gastrectomy (SG) is becoming more popular due to its weight reducing effect and promising anti-diabetic efficacy. However, long term results are still lacking. Methods: The study focuses on anti-diabetic efficacy of SG through retrospective analysis of data for patients who underwent SG in Germany from 2005 to 2011. Anti-diabetic efficacy was assessed at 1, 2 and up to 4 years after surgery. Results: 5400 morbidly obese patients underwent SG. Of these 5400 patients 13.2% (n = 712) were insulin treated (IT) and 21.6% (n = 1165) were non-insulin treated (NIT). Total follow-up was accomplished in 41.24% of patients. Percentage of remission and improvement (RI) at 1 year was 83.8% (80.2% for insulin treated (IT) vs. 85.1% for non-insulin treated (NIT)). RI% at 2 years dropped to 77.6% (76.9% for IT vs. 77.9% for NIT patients). With late follow up (up to 4 years), RI% was 65.9% (58.8% for IT vs. 66.7% for NIT patients). Difference between IT and NIT patients was insignificant. Conclusion: SG shows promising ant-diabetic efficacy at 1 year, 2 years and up to 4 years after surgery. This efficacy gradually drops with prolonged time interval after surgery and seems to be insignificantly higher among NIT vs. IT patients.


Cite this paper
I. El-Sayes, R. Weiner, M. Rad, S. Wolff, C. Knoll, T. Manger and C. Stroh, "Amelioration of Diabetes Mellitus Type II after Sleeve Gastrectomy—Data on Nationwide Survey on Quality Assurance in Bariatric Surgery in Germany," Surgical Science, Vol. 4 No. 12, 2013, pp. 8-12. doi: 10.4236/ss.2013.412A002.
References

[1]   G. Almogy, P. F. Crookes and G. J. Anthone, “Longitudinal Gastrectomy as a Treatment for the High-Risk Super-Obese Patient,” Obesity Surgery, Vol. 14, No. 4, 2004, pp. 492-497. http://dx.doi.org/ 10.1381/096089204323013479

[2]   M. Deitel, R. D. Crosby and M. Gagner, “The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25-27, 2007,” Obesity Surgery, Vol. 18, No. 5, 2008, pp. 487-496. http://dx.doi.org/10.1007/s11695-008-9471-5

[3]   M. Gagner, M. Deitel, T. L. Kalberer, et al., “The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009,” Surgery for Obesity and Related Diseases, Vol. 5, No. 4, 2009, pp. 476-485.

[4]   M. Daskalakis and R. A. Weiner, “Sleeve Gastrectomy as a Single-Stage Bariatric Operation: Indications and Limitations,” Obesity Facts, Vol. 2, No. S1, 2009, pp. 8-10. http://dx.doi.org/10.1159/ 000198239

[5]   C. Stroh, R. Weiner, T. Horbach, K. Adipositas, A. Adipositaschirurgie, et al., “New Data on Quality Assurance in Bariatric Surgery in Germany,” Zentralblatta fur Chirurgie, Vol. 138, No. 2, 2013, pp. 180-188.

[6]   “NIH Conference Gastrointestinal Surgery for Severe Obesity. Consensus Development Conference Panel,” Annals of Internal Medicine, Vol. 115, 1991, pp. 956-961.

[7]   American Diabetes Association, “ADA Standards of Medical Care in Diabetes—2009,” Diabetes Care, Vol. 32, No. S1, 2009, pp. S13-S61.

[8]   J. B. Buse, S. Caprio, W. T. Cefalu, et al., “How Do We Define Cure of Diabetes?” Diabetes Care, Vol. 32, No. 11, 2009, pp. 2133-2135.

[9]   F. X. Pi-Sunyer, “The Effects of Pharmacologic Agents for T2DM on Body Weight,” Postgraduate Medicine, Vol. 120, 2008, pp. 5-17. http://dx.doi.org/10.3810/pgm.2008.07.1785

[10]   B. R. Smith, P. Schauer and N. T. Nguyen, “Surgical Approaches to the Treatment of Obesity: Bariatric Surgery,” Endocrinology and Metabolism Clinics of North America, Vol. 37, No. 4, 2008, pp. 943-964. http://dx.doi.org/10.1016/j.ecl.2008.08.001

[11]   J. S. Todkar, S. S. Shah, P. S. Shah and J. Gangwani, “Long-Term Effects of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Subjects with Type 2 Diabetes Mellitus,” Surgery for Obesity and Related Diseases, Vol. 6, No. 2, 2010, pp. 142-145. http://dx.doi.org/10.1016/j.soard.2009.06.008

[12]   M. Dietel, M. Ganger, A. L. Erickson and R. D. Crosby, “Third International Summit: Current Status of Sleeve Gastrectomy,” Surgery for Obesity and Related Diseases, Vol. 7, No. 6, 2012, pp. 749-759.

[13]   I. Braghetto, C. Davanzo, O. Korn, et al., “Scintigraphic Evaluation of Gastric Emptying in Obese Patients Submitted to Sleeve Gastrectomy Compared to Normal Subjects,” Obesity Surgery, Vol. 19, No. 11, 2009, pp. 1515-1521.

[14]   F. Abbatini, D. Capoccia, G. Casella, F. Coccia, F. Leonetti and N. Basso, “Type 2 Diabetes in Obese Patients with Body Mass Index of 30-35 kg/m2: Sleeve Gastrectomy versus Medical Treatment,” Surgery for Obesity and Related Diseases, Vol. 8, No. 1, 2012, pp. 20-24.

[15]   J. Vidal, A. Ibarzabal, J. Nicolau, et al., “Short-Term Effects of Sleeve Gastrectomy on Type 2 Diabetes Mellitus in Severely Obese Subjects,” Obesity Surgery, Vol. 17, No. 8, 2007, pp. 1069-1074.

[16]   F. Rubino and M. Gagner, “Potential of Surgery for Curing Type 2 Diabetes Mellitus,” Annals of Surgery, Vol. 236, No. 5, 2002, pp. 554-559. http://dx.doi.org/10.1097/00000658-200211000-00003

[17]   M. Rizzello, F. Abbatini, G. Casella, et al., “Early Postoperative Insulin-Resistance Changes after Sleeve Gastrectomy,” Obesity Surgery, Vol. 20, No. 1, 2010, pp. 50-55. http://dx.doi.org/10.1007/ s11695-009-0017-2

[18]   J. Ruiz-Tovar, I. Oller, A. Tomas, et al., “Midterm Impact of Sleeve Gastrectomy, Calibrated with a 50-Fr Bougie, on Weight Loss, Glucose Homeostasis, Lipid Profiles, and Comorbidities in Morbidly Obese Patients,” The American Surgeon, Vol. 78, No. 9, 2012, pp. 969-974.

[19]   F. Abbatini, D. Capoccia, G. Casella, E. Soricelli, F. Leonetti and N. Basso, “Long-Term Remission of Type 2 Diabetes in Morbidly Obese Patients after Sleeve Gastrectomy,” Surgery for Obesity and Related Diseases, Vol. 9, No. 4, 2013, pp. 498-502.

[20]   M. Deitel, “Update: Why Diabetes Does Not Resolve in Some Patients after Bariatric Surgery,” Obesity Surgery, Vol. 21, No. 6, 2011, pp. 794-796.

[21]   P. R. Schauer, B. Burguera, S. Ikramuddin, et al., “Effect of Laparoscopic Roux-En y Gastric Bypass on Type 2 Diabetes Mellitus,” Annals of Surgery, Vol. 238, No. 4, 2003, pp. 467-485.

 
 
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