Impact of sleeve gastrectomy on abnormalities in carbohydrate tolerance in obese adult
##plugins.themes.academic_pro.article.main##
Abstract
Introduction: Facing the repeated failures of the medical management of obesity, bariatric surgery offers a promising therapeutic option in terms of achieving weight loss and metabolic benefits.
Aim: To evaluate the impact of sleeve gastrectomy on the carbohydrate profile of a group of obese subjects.
Methods: It is a prospective study including 40 obese patients (7 Men and 33 Women) who underwent sleeve gastrectomy between 2016 and 2018. Clinical and biological parameters were collected before the intervention, at six months and one year after. Insulin resistance was defined by a HOMA-IR index ≥2.4. Remission of diabetes was determined using the American Society for Metabolic and Bariatric Surgery’s (ASMBS) criteria.
Results:The mean patients’ age was 34.65 ± 8.17 years. The mean body mass index (BMI) was 50.23 ± 8.3 kg/m². One year after sleeve gastrectomy, the frequency of insulin resistance, decreased from 89% to 4% (p<0.05). The evolution of carbohydrate tolerance abnormalities was marked by the diabetes and prediabetes remission in 75% and 100% of cases, respectively. The mean excess weight loss was 55.8% at 12 months.
Conclusion: These results have expanded our knowledge of the short-term sleeve gastrectomy’s effectiveness on the carbohydrate profile of obese subjects. However, it would be interesting to check the durability of this metabolic benefit in the medium and long term.
Keywords:
Obesity, Sleeve gastrectomy, Insulin resistance, Blood glucose, Diabetes##plugins.themes.academic_pro.article.details##
References
- 1. Organisation Mondiale de la Santé. Obésité et surpoids [En ligne]. [cité le 20/05/2019]. Disponible à l'URL : https://www.who.int/fr/news-room/fact_x005F_x0002_sheets/detail/obesity-and-overweight 2. Ministère de la Santé Publique. Rapport de l'enquête nationale THES_x005F_x0002_2016 [En ligne]. [Cité le 20/05/2019]. Disponible à l'UR: http://www.sante. tn/ar/26-actualites/912-rapport-de-l'enquête-national-thes-2016 3. El Ati J, Bader E, Deligia C, Dop MC. Profil nutritionnel de la Tunisie. LA TUNISIE MEDICALE - 2021 ; Vol 99 (n°06) 675 Division de l'alimentation et de la nutrition, FAO, 2005. 4. Organisation Mondiale de la Santé. Profils des pays pour le diabète. Genève: OMS; 2016. 5. Haute Autorité de Santé. Obésité : prise en charge chirurgicale chez l'adulte. Paris: HAS; 2009. 6. Sjöström L. Review of the key results from the swedish obese subjects trial a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219-34. 7. Abelson JS, Afaneh C, Dolan P, Chartrand G, Dakin G, Pomp A. Laparoscopic sleeve gastrectomy: co-morbidity profiles and intermediate_x005F_x0002_term outcomes. Obes Surg. 2016;26(8):1788-93. 8. Ponce J, DeMaria EJ, Nguyen NT, Hutter M, Sudan R, Morton JM. American society for metabolic and bariatric surgery estimation of bariatric surgery procedures in 2015 and surgeon workforce in the United States. Surg Obes Relat Dis. 2016;12(9):1637-9. 9. Oberlin P, Peretti C. Chirurgie de l'obésité : 20 fois plus d'interventions depuis 1997. [En ligne]. [Cité le 20/05/2019]. Disponible à l'UR: https:// drees.solidarites-sante.gouv.fr/IMG/pdf/er1051.pdf 10. Chihaoui M, Sebai I, Oueslati I, Grira W, Yazidi M, Rissouli C, et al. Évolution des paramètres anthropométriques et métaboliques après chirurgie bariatrique : expérience tunisienne monocentrique. Nutr Clin Metab. 2018;32(3):201-7. 11. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes. Diabetes Care. 2019;42 Suppl 1:S13-S28. 12. Gariani K, Hagon Traub I, Philippe J. Diabète de type 1 ou 2? ou autre ? Rev Med Suisse. 2009;5:1248-53. 13. Brethauer SA, Kim J, El Chaar M, Papasavas P, Eisenberg D, Rogers A, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489-506. 14. Li ZJ, Yu JC, Kang WM, Ma ZQ, Ye X, Zhu HJ, et al. Effectiveness of laparoscopic sleeve gastrectomy in treating obesity and its co-morbidities. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018;40(5):610-6. 15. Casella G, Soricelli E, Castagneto Gissey L, Redler A, Basso N, Mingrone G. Changes in insulin sensitivity and secretion after sleeve gastrectomy: changes in insulin sensitivity and secretion after sleeve gastrectomy. Br J Surg. 2016;103(3):242-8. 16. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5(4):469-75. 17. Nath A, LeBlanc KA, Hausmann MG, Kleinpeter K, Allain BW, Romero R. Laparoscopic sleeve gastrectomy: our first 100 patients. JSLS. 2010;14(4):502-8. 18. Ou Yang O, Loi K, Liew V, Talbot M, Jorgensen J. Staged laparoscopic sleeve gastrectomy followed by roux-en-Y gastric bypass for morbidly obese patients: a risk reduction strategy. Obes Surg. 2008;18(12):1575- 80. 19. Wang GF, Yan YX, Xu N, Yin D, Hui Y, Zhang JP, et al. Predictive factors of type 2 diabetes mellitus remission following bariatric surgery: a meta_x005F_x0002_analysis. Obes Surg. 2015;25(2):199-208. 20. Riedel N, Lautenbach A, Wienecke JW, Mann O, Flitsch J, Aberle J. Development of obesity-associated comorbidities post bariatric surgery with a special focus on diabetes remission and short-term relapse. Exp Clin Endocrinol Diabetes. 2018;126(9):577-83. 21. Brethauer SA, Aminian A, Romero Talamás H, Batayyah E, Mackey J, Kennedy L, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258(4):628-36. 22. Gayet C, Badic B, Guinard S, Kansou G, Dileon S, Attari M, et al. Résultats à long terme de la sleeve gastrectomie pour obésité morbide. Tunis Med. 2013;91(10):605-9. 23. Lessing Y, Pencovich N, Lahat G, Klausner JM, Abu Abeid S, Meron Eldar S. Laparoscopic sleeve gastrectomy for diabetics 5 year outcomes. Surg Obes Relat Dis. 2017;13(10):1658-63. 24. Basso N, Capoccia D, Rizzello M, Abbatini F, Mariani P, Maglio C, et al. First-phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients: the gastric hypothesis. Surg Endosc. 2011;25(11):3540-50. 25. Cornu M, Thorens B. GLP-1 protects β-cells against apoptosis by enhancing the activity of an IGF-2/IGF1-receptor autocrine loop. Islets. 2009;1(3):280-2. 26. Drucker DJ. Glucagon-like peptide-1 and the islet β-cell: augmentation of cell proliferation and inhibition of apoptosis. Endocrinology. 2003;144(12):5145-8. 27. American Diabetes Association. 8. Obesity management for the treatment of type 2 diabetes: standards of medical care in diabetes. Diabetes Care. 2020;43 Suppl 1:S89-S97