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Obesity Surgery
Published in: Obesity Surgery 12/2016

01-12-2016 | Original Contributions

Impact of Sleeve Gastrectomy on Type 2 Diabetes Mellitus, Gastric Emptying Time, Glucagon-Like Peptide 1 (GLP-1), Ghrelin and Leptin in Non-morbidly Obese Subjects with BMI 30–35.0 kg/m2: a Prospective Study

Authors: B. Vigneshwaran, Akshat Wahal, Sandeep Aggarwal, Pratyusha Priyadarshini, Hemanga Bhattacharjee, Rajesh Khadgawat, Rajkumar Yadav

Published in: Obesity Surgery | Issue 12/2016

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Abstract

Background

The study was conducted to evaluate the impact of laparoscopic sleeve gastrectomy (LSG) on type 2 diabetes mellitus (T2DM) in patients with a body mass index (BMI) of 30.0–35.0 kg/m2. Possible mechanisms, including alterations in gastric emptying time (GET), glucagon-like peptide 1 (GLP-1), ghrelin and leptin, were evaluated.

Methods

Twenty obese patients with T2DM and with a BMI of 30.0–35.0 kg/m2 underwent LSG during March 2012 to February 2015. Glycosylated haemoglobin (HbA1c), fasting plasma glucose (FPG) and GET were measured at baseline, 3 months, 6 months, 12 months and 24 months after surgery. Fasting and post-prandial levels of serum GLP-1, ghrelin and leptin were measured pre-operatively and after 3 and 6 months.

Results

The average duration of follow-up was 17.6 months, and 10 patients had completed 2 years of follow-up. After 2 years, the average BMI decreased from 33.4 ± 1.2 to 26.7 ± 1.8 kg/m2. The mean HbA1c decreased from 8.7 ± 1.6 to 6.7 ± 1.5 %, respectively. Ten patients achieved complete remission. Insulin could be stopped in all six patients who were on it pre-operatively. Meal-stimulated GLP-1 response and serum insulin at 30 min showed a significant increase following surgery. There was a significant decrease in GET.

Conclusions

This prospective study confirms the positive impact of LSG on diabetic status of non-morbidly obese patients. The possible mechanisms include the rise in post-prandial GLP-1 level induced by accelerated gastric emptying, leading to an increase in insulin secretion. LSG also leads to decreased ghrelin and leptin levels which may have a role in improving glucose homeostasis after surgery.
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Metadata
Title
Impact of Sleeve Gastrectomy on Type 2 Diabetes Mellitus, Gastric Emptying Time, Glucagon-Like Peptide 1 (GLP-1), Ghrelin and Leptin in Non-morbidly Obese Subjects with BMI 30–35.0 kg/m2: a Prospective Study
Authors
B. Vigneshwaran
Akshat Wahal
Sandeep Aggarwal
Pratyusha Priyadarshini
Hemanga Bhattacharjee
Rajesh Khadgawat
Rajkumar Yadav
Publication date
01-12-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2226-9

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