This document summarizes a study on the effects of sleeve gastrectomy on type 2 diabetic obese patients. 63 patients underwent sleeve gastrectomy and were followed for an average of 24 months. Prior to surgery, most patients had well-controlled type 2 diabetes treated with oral medications. After surgery, patients experienced significant weight loss and 87% achieved remission of their diabetes as measured by normal fasting blood glucose and HbA1c levels. There were no deaths or need for reoperation. The study concludes that sleeve gastrectomy is a safe and effective treatment for obese patients with well-controlled type 2 diabetes.

1. SLEEVE GASTRECTOMY IN TYPE 2
DIABETIC OBESE PATIENTS (DM2)
Authors:
Dr, M. Berry,
Drs.P. Lamoza, L. Urrutia, R. Rossi, A. Bustos
Bariatric Surgical Unit , Clinica Las Condes,
Santiago – Chile.
World IFSO Turkey
August 29, 2013

2. IntroductionIntroduction
• The T2DM is a major cause of mortality worldwide.
• About 60% of the diabetic population has some degree
of obesity.
• We know from the literature on obesity surgery, which
all bariatric surgical techniques solve the T2DM from
73% to 98% in obese patients, this remission occurs
days to weeks after surgery.

3. Concepts
• Medically, cure may be defined
as restoration to good health,
while remission is defined as
abatement or disappearance
of the signs and symptoms of
a disease. Implicit in the latter is
the possibility of recurrence ofrecurrence of
the disease.the disease.

4. Treatment GoalsTreatment Goals
• DIABETES CARE, VOLUME 35, SUPPLEMENT 1, JANUARY 2012

5. Indication for Surgery in T2DMIndication for Surgery in T2DM
• DIABETES CARE, VOLUME 35, SUPPLEMENT 1, JANUARY 2012

6. ObjectiveObjective
• Evaluate the results of
metabolic control in the
treatment of obese patients
with T2DM undergoing LSG.

7. Material and MethodsMaterial and Methods
•63 patients with T2DM
•LSG between April 2006 and January 2012.
•Patients included
- Patients with newly diagnosed DM2.
- T2DM patients "well-controlled“.
- T2DM patients who refused gastric bypass as a therapeutic alternative
(regardless of the quality of metabolic control).
•Patients Excluded
– Patients with > 10 years of T2DM of diagnosis.
– Patients using insulin.
– T1DM.

8. Material and MethodsMaterial and Methods
•Surgical technique:
- Vertical gastrectomy calibrated 36Fr, 4 cm from the pylorus to the angle of Hiss.
- Seamguard ® reinforcement.
- Drain along the suture line
•Mean Follow-up: 24 months (6-46) .

9. Material and MethodsMaterial and Methods
• Evaluation:
- Demographics: Gender, Age
- BMI.
- Fasting blood glucose.
- HbA1c.
- Treatment.
- Morbidity.
- Mortality.

10. ResultsResults
•N=63
• Age: 50 years old (24-70).

11. ResultsResults
T2DM
Time of diagnosis 34 Months (0 – 112)
2 Patients newly
Diagnosed at
Preoperative Tests
Treatment
Without
Treatment
2 3%
Non
Pharmacological
0 0%
Pharmacological Monotherapy (55 patients) 87%
Bitherapy (6 patients) 10%

12. ResultsResults
BMIBMI
36,4 (30,2 – 51) 27,6 (35 – 21,6)

13. ResultsResults
GlycemiaGlycemia
151 (250 – 84) 95 (120 – 72)

14. ResultsResults
HbA1cHbA1c
7,05 (5,2-11,6) 5,79 (5,3-6,9)

15. ResultsResults
Treatment up to 24 months n % Remission
Not Initiated Medical Treatment 2 3%
87%
Non Pharmacological 53 84%
Monotherapy (MTF) 2 3% Improvement
Lost of F/U 6 10%

16. ResultsResults
• Conversions: 0
• Morbidity
– 2 patients (3%):
• 1 hemoperitoneum.
• 1 Perigastric hematoma.
• Reoperations: 0
• Mortality: 0%

17. DiscussionDiscussion
• In our study, LSG is a safe and effective
treatment for patients with well-controlled
T2DM, achieving remission in 87% of cases.

18. DiscussionDiscussion

19. DiscussionDiscussion
• Close F/U is needed to assess the long-term
result, which could provide valuable information
to optimize the selection of patients for this
procedure.

20. Thank You Very MuchThank You Very Much
mberry@clc.clmberry@clc.cl
questions: 1)insulin levels pre and post
2)Partial vs complete remision