title: The effect of laparoscopic sleeve gastrectomy (LSG) on glycemic control in morbidly obese patients.
abstract: BACKGROUND
  Bariatric procedures have become popular in treating not only the morbid obesity but also the metabolic derangements. Sleeve Gastrectomy has recently become popular as a standalone procedure and its usefulness as a metabolic procedure especially glycemic control is still under investigation. One of the most commonly used measure of insulin resistance is statistically derived 'Homeostatic model assessment of insulin resistance (HOMA-IR).
  
  
  OBJECTIVE
  The effect of Laparoscopic Sleeve Gastrectomy (LSG) on clinical and measurable change in glycemic control as seen by reduction of insulin resistance ie HOMA-IR levels in morbidly obese patients.
  
  
  METHODS
  All the patients with BMI ≥35 kg/m(2) with co morbidities and BMI ≥40 kg/m(2) even without co morbidities were included in the study. The period of the study was from Feb 2013 to Sep 2014. Fasting (FBS), post prandial blood sugar (PPBS) and Insulin levels were checked before the surgery, 1month and 3 month after the surgery. We also recorded BMI and diabetic status. HOMA-IR was calculated and trends were recorded.
  
  
  METHODS
  Statistical analysis was carried out using SPSS 16.0.
  
  
  RESULTS
  Out of 28 patients 8 were males and 20 were females. The mean age was 43 yrs. 11 (39%) patients were diabetic and mean BMI was 44 kg/m(2) and a range of (35-61.3) kg/m(2). 11 patients had BMI > 45 kg/m(2). The HOMA-IR values decreased significantly after the surgery both in diabetics and non diabetics.
  
  
  CONCLUSIONS
  LSG results in improvement in glycemic control in both diabetics and non diabetics.
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India. Electronic address: docamitgaur@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Gaur
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: C S
authors.initials: CS
authors.lastname: Naidu
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: P P
authors.initials: PP
authors.lastname: Rao
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Singh
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: V
authors.initials: V
authors.lastname: Trehan
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: S V
authors.initials: SV
authors.lastname: Kulkarni
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: Nishant
authors.initials: N
authors.lastname: Pathak
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
authors.forename: Balram
authors.initials: B
authors.lastname: Goyal
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007333:Insulin Resistance; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*
chemical_list: D001786:Blood Glucose
keywords: Diabetes mellitus; HOMA-IR; Laparoscopic sleeve gastrectomy