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Obesity Surgery
Published in: Obesity Surgery 3/2021

01-03-2021 | Obesity | Original Contributions

Weight Loss After Sleeve Gastrectomy: Does Type 2 Diabetes Status Impact Weight and Body Composition Trajectories?

Authors: Marc Diedisheim, Christine Poitou, Laurent Genser, Chloé Amouyal, Jean-Luc Bouillot, Cecile Ciangura, Jean-Michel Oppert, Karine Clément, Judith Aron-Wisnewsky

Published in: Obesity Surgery | Issue 3/2021

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Abstract

Introduction/ purpose:

Sleeve gastrectomy (SG), the most frequently performed bariatric procedure, induces marked weight-loss, but with high inter-individual variability. Since type 2 diabetes (T2D) negatively impacts weight-loss outcomes after Roux-en-Y gastric bypass (RYGB), we herein aimed to evaluate whether and how T2D status may influence weight-loss and body composition changes in individuals with or without T2D after SG.

Material and Methods:

We retrospectively included individuals with obesity operated from SG and prospectively followed at our center: 373 patients including 152 with T2D (40%). All subjects’ clinical characteristics were collected before and during 4 years of follow-up post-SG. Linear mixed models were applied to analyze weight-loss trajectories post-surgery.

Results:

Compared to individuals with obesity but no T2D, those with T2D before SG displayed lower weight-loss at 1 year (21 vs. 27% from baseline, p < 10−3). This difference was accentuated in patients with poorer glucose control (HbA1c > 7%) at baseline. Furthermore, patients with T2D underwent less favorable body composition changes at 1-year post-SG compared to individuals without T2D (% fat mass reduction: 28 vs. 37%, p < 10−3 respectively).

Conclusion:

When undergoing SG, subjects with obesity and T2D who have poor pre-operative glycemic control display reduced weight-loss and less improvement in body composition compared to patients with obesity but without T2D. This result suggests that glycemic control prior to surgery is important to take into account for the outcome of bariatric surgery.
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Metadata
Title
Weight Loss After Sleeve Gastrectomy: Does Type 2 Diabetes Status Impact Weight and Body Composition Trajectories?
Authors
Marc Diedisheim
Christine Poitou
Laurent Genser
Chloé Amouyal
Jean-Luc Bouillot
Cecile Ciangura
Jean-Michel Oppert
Karine Clément
Judith Aron-Wisnewsky
Publication date
01-03-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-05075-1

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