title: Long-term remission of type 2 diabetes in morbidly obese patients after sleeve gastrectomy.
abstract: BACKGROUND
  The aim of this study was to evaluate the long-term effects of laparoscopic sleeve gastrectomy (LSG) on type 2 diabetes mellitus (T2DM) and other related co-morbidities in severely obese patients.
  
  
  METHODS
  From May 2003 to July 2008, 33 morbidly obese diabetic patients (20 with body mass index [BMI]>50 kg/m(2)) underwent LSG. A total of 23 females and 10 males participated, with a mean age of 49.3±8 years, mean preoperative BMI of 52.1±8.5 kg/m(2), mean fasting plasma glucose (FPG) of 143.2±47.9 mg/dL, mean glycosylated hemoglobin (HbA1c) of 7.3%±1.4%, and a mean T2DM duration of 7 years. All patients had a 36-month follow-up, and 13 had a 60-month follow-up.
  
  
  RESULTS
  Twenty-nine patients (87.8%) discontinued antidiabetic medications 3 months after LSG, (mean BMI of 42.8±7.8 kg/m(2); FPG of 104.5±22.1 mg/dL; HbA1c of 5.3%±.4%). At 36 months, 22 of 26 LSG patients (84.6%) had normal FPG and HbA1c values without antidiabetic therapy. At the 60-month follow-up, 10 of 13 patients (76.9%) had normal FPG and HbA1c values without antidiabetic therapy. The Framingham risk score decreased significantly from 9.7% preoperatively to 4.7% postoperatively. No new diabetic retinopathy occurred during the whole period of observation.
  
  
  CONCLUSIONS
  This study confirms the efficacy of LSG in the treatment of T2DM and indicates that, at both 36- and 60-month follow-ups, LSG can provide a significant percentage of treated patients with a prolonged remission of T2DM, with diminished cardiac risk factors and no development of diabetic retinopathy. These results compare favorably with those reported after standard medical therapy.
authors.affiliation: Surgical-Medical Department for Digestive Diseases, Policlinico Umberto I, University of Rome Sapienza, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Abbatini
authors.forename: Danila
authors.initials: D
authors.lastname: Capoccia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casella
authors.forename: Emanuele
authors.initials: E
authors.lastname: Soricelli
authors.forename: Frida
authors.initials: F
authors.lastname: Leonetti
authors.forename: Nicola
authors.initials: N
authors.lastname: Basso
mesh_terms: D008076:Cholesterol, HDL / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: Bariatric; Metabolic surgery; Obesity; Sleeve gastrectomy; Type 2 diabetes