Faculty Collaboration Database

Comparing Diabetes Outcomes: Weight-independent Effects of Sleeve Gastrectomy Versus Matched Patients With Similar Weight Loss. Ann Surg 2022 May 01;275(5):924-927

Date

11/18/2020

Pubmed ID

33201112

DOI

10.1097/SLA.0000000000004298

Scopus ID

2-s2.0-85129998607 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

OBJECTIVE: To determine if sleeve gastrectomy has weight-independent benefits on diabetes outcomes.

SUMMARY BACKGROUND DATA: Weight loss is recommended when treating conditions such as diabetes, hypertension, and hyperlipidemia. Bariatric surgery has been shown to improve or resolve metabolic conditions, but weight loss outcomes vary by procedure type.

METHODS: Using data from a statewide bariatric surgery registry, a total of 988 patients with a preoperative diagnosis of diabetes who underwent either laparoscopic sleeve gastrectomy (LSG) or laparoscopic adjustable gastric banding (LAGB) were included in the study. The patients were matched based on age, race, sex, preoperative body mass index (BMi) and weight loss at 1 year after surgery. Chi-square comparisons were conducted for medication discontinuation for diabetes. Secondary outcome measures included discontinuation of medications for hypertension and hyperlipidemia.

RESULTS: The mean age of patients was 53.9 years, 75.5% were female, 89.3% were White. Mean preoperative BMi was 44.8 kg/m2 and 75.7% had noninsulin dependent diabetes, whereas 24.3% had insulin dependent diabetes. Mean % BMi loss at 1 year is similar between the 2 groups (8.3% vs 8.1%, P = 0.3811). LSG patients had significantly higher rates of discontinuation of oral diabetes medication (70.4% vs 46.0%, P < 0.0001), insulin (51.7% vs 38.3%, P = 0.0341), anti-hypertensive (41.1% vs 26.0%, P < 0.0001), and cholesterol-lowering medications (40.1% vs 27.8%, P = 0.0016) when compared to LAGB patients.

CONCLUSIONS: Despite similar preoperative characteristics and postoperative weight loss, LSG patients experienced significantly higher rates of medication discontinuation for diabetes, hypertension, and hyperlipidemia than LAGB. These results suggest that LSG may have weight-independent effects on metabolic disease and should be considered in the treatment of diabetes, regardless of perceived weight loss outcomes.

Author List

Yang P, Bonham AJ, Ghaferi AA, Varhan OA

Author

Amir Ghaferi MD President, Phys Enterprise & SAD Clinical Affairs in the Medical College Physicians Administration department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Body Mass Index
Diabetes Mellitus
Female
Gastrectomy
Gastric Bypass
Gastroplasty
Humans
Hypertension
Insulins
Laparoscopy
Male
Middle Aged
Obesity, Morbid
Retrospective Studies
Treatment Outcome
Weight Loss