Effectiveness of laparoscopic sleeve gastrectomy on glycemic control in obese Indians with type 2 diabetes mellitus

Background: To prospectively evaluate the efficacy and safety of laparoscopic sleeve gastrectomy (LSG) in Indian subjects with type 2 diabetes mellitus and a body mass index >33 kg/m(2) in a tertiary care hospital in Pune, India. Morbid obesity associated with type 2 diabetes mellitus has many health implications. A definitive long-term strategy is needed to control obesity and its deleterious effects. LSG is one such approach. Methods: The patients who underwent LSG were followed up until the end of 1 year after surgery. The change in hemoglobin Ale levels, waist circumference, total body weight, and the use of oral hypoglycemic agents and insulin were studied. Results: A total of 53 patients (24 men and 29 women, age 46.5 +/- 8.7 years, body mass index 45.2 +/- 9.3 kg/m(2), waist circumference 117 +/- 18 cm, and hemoglobin Ale 8.4% +/- 1.6%) fulfilled the entry criteria and underwent LSG. Before LSG, 48 patients (79%) required antidiabetic medication (oral hypoglycemic agents and insulin) and 5 managed their diabetes with diet control. At I month after LSG, 39 (81.2%) of 48 patients no longer required antidiabetic medications and had achieved euglycemia with diet control alone. The use of antidiabetic medications was reduced in 9 (18.8%) of 52 patients. At 1 year, euglycemia was observed in 51 patients (96.2%) without medication and 2 (3.8%) of the 53 patients had reduced their medication dosage. Conclusion: LSG is an effective adjunct in the treatment of type 2 diabetes mellitus in obese individuals. It appears that improvement in glycemic control is achieved even before weight reduction, and the possible mechanisms explaining this need further investigation. (Surg Obes Relat Dis 2010;6:138-141.) (C) 2010 American Society for Metabolic and Bariatric Surgery. All rights reserved.