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    • Effect of Laparoscopic Sleeve Gastrectomy in Treatment of Type II Diabetes Mellitus

    Ragai S. Hanna1, George Abdelfady Nashed2, Gamal A Makhlouf 3, Nahed A Makhlouf 4, Manal El Sayed Abdelmooty 5
    1,3General Surgery Department. Faculty of Medicine, Assiut University; 2General and Bariatric Surgery, Faculty of Medicine, Cairo University. Egypt; 4Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University; 5Department of Internal Medicine (Endocrinology Unit), Faculty of Medicine, Assiut University

    Introduction: Excess body weight can result in Diabetes mellitus, where 90% of all diabetics are type 2 (T2DM). Aim of study: To evaluate the effect of Laparoscopic Sleeve Gastrectomy (LSG) as a method of treatment of type 2 Diabetes mellitus in morbidly obese patients. Patients and methods: A prospective study was carried out on 40 diabetic morbidly obese patients who underwent LSG during 1.5 years. The pre-operative diabetic status, duration of Diabetes, body mass index, the excess weight loss percent (EWL %) at 12 and 18 months follow-up, and remission or improvement of T2DM were recorded and analyzed. Pre- and postoperative fasting blood glucose, and HbA1C were measured. In addition, Continuous Glucose Monitoring (CGM) was performed in each patient to clarify the remission of Diabetes. Results: The mean age of patients was 40.1±4.7 years. The mean preoperative BMI was 51.2±6.5 Kg/m2 . Postoperative calf DVT and bleeding occurred in 5% of cases. Diabetes resolution occurred in 87.5% of patients (n = 35), where the blood sugar control started at 3 months and reached to no medication at 6 months for 28 patients and 7 patient reached complete cure at 18 months. Diabetes was controlled on oral hypoglycemic only and a minimal dose was required in 12.5% of patients(n = 5). The EWL% was 70.2% at 12 months and 72.7% at 18 months. Conclusion: LSG resulted in total remission of T2DM in 87.5% of the patients and easy control of diabetes in 12.5% of patients, and can be considered a metabolic surgery. Key words: LSG; Type 2 DM; excess weight loss. 

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