title: Is type 2 diabetes really resolved after laparoscopic sleeve gastrectomy? Glucose variability studied by continuous glucose monitoring.
abstract: The study was carried out on type 2 diabetic obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Patients underwent regular glycemic controls throughout 3 years and all patients were defined cured from diabetes according to conventional criteria defined as normalization of fasting glucose levels and glycated hemoglobin in absence of antidiabetic therapy. After 3 years of follow-up, Continuous Glucose Monitoring (CGM) was performed in each patient to better clarify the remission of diabetes. In this study, we found that the diabetes resolution after LSG occurred in 40% of patients; in the other 60%, even if they showed a normal fasting glycemia and A1c, patients spent a lot of time in hyperglycemia. During the oral glucose tolerance test (OGTT), we found that 2 h postload glucose determinations revealed overt diabetes only in a small group of patients and might be insufficient to exclude the diagnosis of diabetes in the other patients who spent a lot of time in hyperglycemia, even if they showed a normal glycemia (<140 mg/dL) at 120 minutes OGTT. These interesting data could help clinicians to better individualize patients in which diabetes is not resolved and who could need more attention in order to prevent chronic complications of diabetes.
authors.affiliation: Department of Experimental Medicine, Division of Diabetes and Metabolic Diseases, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Capoccia
authors.affiliation: Department of Experimental Medicine, Division of Diabetes and Metabolic Diseases, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Coccia
authors.affiliation: Department of Experimental Medicine, Division of Diabetes and Metabolic Diseases, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Guida
authors.affiliation: Department of Medical Surgical Sciences and Biotechnology, Division of General Surgery, ICOT, Sapienza University of Rome, 04100 Latina, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rizzello
authors.affiliation: Department of Medical Surgical Sciences and Biotechnology, Division of General Surgery, ICOT, Sapienza University of Rome, 04100 Latina, Italy.
authors.forename: F
authors.initials: F
authors.lastname: De Angelis
authors.affiliation: Department of Medical Surgical Sciences and Biotechnology, Division of General Surgery, ICOT, Sapienza University of Rome, 04100 Latina, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Silecchia
authors.affiliation: Department of Experimental Medicine, Division of Diabetes and Metabolic Diseases, Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Leonetti
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin