Περίληψη:
Global rise in the incidence of obesity and type 2 diabetes mellitus is
widely recognized as one of the most challenging contemporary threats to
public health. Weight loss surgery has proven to be an effective and
durable solution for morbidly obese adults. Laparoscopic sleeve
gastrectomy (LSG) was introduced as a restrictive procedure for obese
patients, initially described as a possible first-stage operation, but
now commonly performed as a stand-alone bariatric operation for both
high-risk and super-morbid-obese patients, as well as for patients with
lower body mass index. This study aims to evaluate the progression of
glucose metabolism in patients undergoing LSG.
This prospective study investigated 62 patients who underwent LSG by the
same surgical team in an 18-month period. Preoperative evaluation
included demographic information, complete medical history including
comorbidities and medication, clinical examination, evaluation of
cardiopulmonary function, measurement of weight and height on a standard
electronic scale, upper gastrointestinal endoscopy and upper abdominal
ultrasound, as well as interviews with a psychologist and nutritionist.
Glucose metabolism was evaluated by oral glucose tolerance test (OGTT),
preoperatively and at 3, 6, and 12 months after surgery.
The OGTT was significantly ameliorated in all groups during follow-up.
Nine of 12 diabetic patients (75 %) ceased drug treatment at 3 months
postoperatively (p = 0.004), increasing to 100 % at 1-year follow-up (p
< 0.001). Normoglycemic patients and patients with borderline OGTT
experienced mild or severe hypoglycemia during the glucose tolerance
test at 3, 6, and 12 months’ follow-up.
LSG offers excellent results to morbidly obese patients with regard to
type 2 diabetes mellitus. Implementation of OGTT in these patients can
be a valuable tool in their postoperative management. Bariatric teams
performing LSG for morbid obesity should heighten their sensitivity to
postoperative hypoglycemia, even in patients with type 2 diabetes
mellitus.
Συγγραφείς:
Natoudi, Maria
Panousopoulos, Sotirios-George
Memos, Nikolaos
and Menenakos, Evangelos
Zografos, George
Leandros, Emmanuel and
Albanopoulos, Kostandinos
