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Obesity Surgery
Published in: Obesity Surgery 11/2015

01-11-2015 | Original Contributions

Immediate Metabolic Response Following Sleeve Gastrectomy in Obese Diabetics

Authors: Chanan Meydan, Nir Goldstein, Efrat Weiss-Shwartz, Doron Lederfine, David Goitein, Moshe Rubin, Hadar Spivak

Published in: Obesity Surgery | Issue 11/2015

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Abstract

Background

Although laparoscopic sleeve gastrectomy (LSG) has been shown to have a long-term antidiabetic effect, little is known regarding the immediate response to surgery. This study’s objective was to evaluate the glycemic and lipid metabolic response in the first postoperative week.

Methods

The study included 21 obese diabetic participants. Glycemic markers, lipids, and hepatic function tests were measured just prior to surgery and at 1 week and 3 months postoperatively. Two participants were dropped prior to all measurements due to technical reasons, and two more were lost to follow-up.

Results

At 1 week after surgery, compared to preoperative baseline, we found reduced hemoglobin A1c (7.63 to 7.31, P < 0.001), insulin (24.96 to 10.92, P < 0.05), and borderline significant homeostatic model assessment insulin resistance (HOMA-IR, 9.48 to 3.91, P > 0.05). Low-density lipoprotein (LDL) cholesterol increased and high-density lipoprotein (HDL) cholesterol decreased. Three months after surgery, hemoglobin A1c, insulin, and HOMA-IR continued to decrease (6.05, 7.11, and 1.92, respectively, P < 0.05), with hemoglobin A1c correlated to weight loss (P < 0.05). Triglycerides, triglyceride to HDL ratio, and total cholesterol to HDL ratio also decreased, but there was no significant change in LDL cholesterol or HDL versus presurgery levels. Reduced triglyceride levels were correlated with reduced alanine transaminase (ALT) and gamma-glutamyl transpeptidase (GGT) (P < 0.05).

Conclusions

LSG is associated with marked antidiabetic effects as early as 1 week after surgery, unrelated to weight loss. The antidiabetic effect improves at 3 months. Triglyceride reduction was associated with improved hepatic functions, but cholesterol did not show a meaningful reduction.
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Metadata
Title
Immediate Metabolic Response Following Sleeve Gastrectomy in Obese Diabetics
Authors
Chanan Meydan
Nir Goldstein
Efrat Weiss-Shwartz
Doron Lederfine
David Goitein
Moshe Rubin
Hadar Spivak
Publication date
01-11-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 11/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1669-8

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