| Background:laparoscopic sleeve gastrectomy has been proved to be the effective treatment strategy for the treatment of type 2 diabetes mellitus(T2DM)with a body mass index index≥35kg/m~2 achieving high remission rates.However,there are few clinical studies on the treatment of T2DM patients with a body mass index less than 35kg/m~2 by LSG.This study aims to study the effect of laparoscopic sleeve gastrectomy(LSG)on type 2 diabetes mellitus(T2DM)in patient with a body mass index less than 35kg/m~2.Objective:To investigate the effect of laparoscopic sleeve gastrectomy(LSG)on type 2 diabetes mellitus(T2DM)in patients with a body mass index less than 35kg/m~2.Methods:The clinical data of 51 patients with type 2 diabetes mellitus(T2DM)and body mass index less than 35kg/m~2 who were treated by laparoscopic sleeve gastrectomy(LSG)in China-Japan Union Hospital of JiLin university from May 2016 to May 2017 were retrospectively analyzed.Follow-up was performed by outpatient examination,telephone and wechat up to June 2018 at 3 months,6 months and 12 months after operation,respectively,including fasting plasma glucose,glycosylated hemoglobin,body weight,body mass index,waist circumference,and fasting C-peptide.Measurement data were represented as Mean±SD,and they were analyzed by SPSS 22.0.They were tested with a single sample K-S test to determine whether they were normal distribution data.The normal distribution data were analyzed by a matched t test and Mann-Whitney test was used to examine skewed data.Results:All patients(19 males,32 females)with a median age of 50(24-65)years were treated successfully by laparoscopic sleeve gastrectomy.The median duration of type 2 diabetes mellitus was 5(0-20)years.The preoperative fasting plasma glucose,glycosylated hemoglobin,fasting C-peptide,body weight,body mass index and waist circumference were(9.76±2.50)mmol/L,(8.12±1.38)%,(6.09±4.34)nmol/L,(84.54±13.30)kg,(30.04±2.75)kg/m~2 and(104.25±7.74)cm,respectively.The meaning fasting plasma glucose was(6.88±1.24)mmol/L,(6.46±0.98)mmol/L and(6.14±0.95)mmol/L(P=0.000,0.046,0.042),respectively,at 3,6 and 12months after operation.The mean HbAlc in the same observation intervalswas(6.55±1.01)%,(6.26±0.86)%and(6.05±0.81)%(P=0.000,0.081,0.105),respectively.ThefastingC-peptidewas(4.09±2.58)nmol/L,(3.87±2.32)nmol/L and(3.71±2.11)nmol/L(P>0.05),respectively.The body weight was(69.41±11.34)kg,(65.54±10.61)kg and(63.12±9.51)kg(P=0.000,0.000,0.000),respectively.The correspondingbodymassindexwas(24.68±2.62)kg/m~2,(23.25±2.41)kg/m~2and(22.42±1.97)kg/m~2(P=0.000,0.000,0.000),respectively.Thewaistcircumferencewas(88.49±8.29)cm,(83.72±7.39)cm and(81.04±6.27)cm(P=0.000,0.000,0.000),respectively.The total weight loss was(17.90±4.02)%,(22.46±3.95)%and(25.11±4.85)%(P=0.000,0.000).Theexcessweightlosswas(121.44±243.55)%,(158.23±344.20)%and(164.66±318.17)%(P=0.04,0.103).The complete remission rate of type 2 diabetes in patients with BMI<35kg/m~2 were 25.5%,49%and 66.7%,respectively,at 3,6and 12 months after operation.On the one hand,the effect of type 2diabetes patients with BMI of 30-34.9kg/m~2 was excellent,with a complete remission of 88.5%,while that of type 2 diabetes patients with BMI<30kg/m~2 was poor,with a complete remission rate of 44%.Besides,the effect of T2DM patients with a diabetic duration≥11 years and ABCD scores≤2 were poor,with a complete remission rate of 18.2%and 15.4%,respectively.Conclusion:Laparoscopic sleeve gastrectomy has a significant effect on patients with type 2 diabetes mellitus whose BMI is less than 35kg/m~2 in a short time,and the curative effect of mild obesity patients was significantly higher than that of patients with a BMI less than 30kg/m~2,but its long-term effectiveness need to be further followed up. |
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