Role of operation of longitudinal gastric resection in guaranteeing of glycemic control in patients, suffering diabetes mellitus type II and obesity

Keywords: morbid obesity; sleeve gastrectomy; gastric shunting; type II diabetes mellitus; bariatric surgery

Abstract

Objective. To study a correlation between control of the glycaemia level and degree of the body mass index (BMI) in patients after bariatric operation.

Маterials and methods. Control of the glucose metabolism level was conducted in 84 patients, suffering prediabetes and diabetes mellitus type II, morbid obesity after the gastric reduction operation.

Results. In 30/84 (35.7%) patients the diabetes mellitus type II duration have constituted 1 year, in 27 (32.1%) – 10 years, and in 12 (14.3%) – more than 10 years. In 15 (17.9%) patients a prediabetes was diagnosed. While studying of anthropometric indices a BMI lowering by 38% postoperatively, comparing with initial indices, was noted. The BMI have lowered from 46.8 (41.3 – 54.3) tо 27.6 (25.4 – 30.9) kg/m2 (р = 0.001). In 2 years postoperatively a general lowering of the body mass, comparing with primary indices, have constituted 42%, аnd BMI have lowered tо 26.8 (23.1 – 28.4) kg/m2. Remission of diabetes mellitus type II in terms of observation 1 - 3 years was noted in 82 (98.6%) patients (level of glycaemized hemoglobin lesser than 6.0%, glucose in fasting state lesser than 5,6 mmol/l).

Conclusion. Results of the investigation conducted have shown, that longitudinal gastric resection  in patients, suffering diabetes mellitus type II is effective not only for the BMI lowering, but for the metabolic syndrome as well. In postoperative period in them a stability of the glycaemia and carbohydrate metabolism indices was followed.

Author Biographies

T. Omarov, Аzerbaijani Medical University, Baku, Аzerbaijani Republic

Taryel Omarov, MD, PhD, assistant professor

Assistant professor

Azerbaijan Medical University I Surgical Diseases Department

AZ1022, Baku city, Nasimi district, 23, Bakikhanov st.

Mobile phone +994557900109

E-mail:taryel.omerov@gmail.com

ORCID:0000-0003-1220-242X

S. Salahova, Аzerbaijani Medical University, Baku, Аzerbaijani Republic

Sevinc Salahova, MD, PhD, assistant professor

Assistant professor

Azerbaijan Medical University I Surgical Diseases Department

AZ1022, Baku city, Nasimi district, 23, Bakikhanov st.

Mobile phone +994503151717

E-mail: salahovaseva@yahoo.com

ORCID:0000-0002-0164-7928

A. Ibrahimova, Аzerbaijani Medical University, Baku, Аzerbaijani Republic

Aygun İbrahimova, MD

Azerbaijan Medical University I Surgical Diseases Department

AZ1022, Baku city, Nasimi district, 23, Bakikhanov st.

Mobile phone +99470 342 43 94

E-mail: dr.a.ibrahimova@gmail.com

ORCID:0000-0002-1676-7594

N. Bayramov, Аzerbaijani Medical University, Baku, Аzerbaijani Republic

Nuru Bayramov,  MD, DSci (Med), professor

Professor and chief Azerbaijan Medical University I Surgical Diseases Department

Adress: AZ1022, Baku city, Nasimi district, 23, Bakikhanov st. Mobile phone +994502222708

E-mail:nurubay2006@yahoo.com

ORCID: 0000-0001-6958-5412

References

1. Hayes K, Eid G. Laparoscopic Sleeve Gastrectomy: Surgical Technique and Perioperative Care. Surg Clin North Am. 2016 Aug;96(4):763-71. doi:10.1016/j.suc.2016.03.015.
2. Golomb I, Ben David M, Glass A, Kolitz T, Keidar A. Long-Term Metabolic Effects of Labaroscopic Sleeve Gastrectomy. JAMA Surg. 2015 Nov;150(11):1051-7. doi:10.1001/jamasurg.2015.2202
3. Buchwald H, Estok R, Fahrbach K. Weight and type 2 diabetes after bariatric surgery: systemic review and meta-analysis. Am J Med. 2009 Mar;122(3):248-56. doi:10.1016/j.amjmed.2008.09.041.
4. Collier A. Bariatric surgery and diabetes. Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S230-2. doi: 10.15406/jdmdc.2017.04.00110.
5. Demaria E, Winegar D, Pate V. Early postoperative outcomes of metabolic surgery to treat diabetes from sites participating in the ASMBS bariatric surgery center of excellence program as reported in the Bariatric Outcomes Longitudinal Database. Ann Surg. 2010 Sept; 252(3):559-66. doi:10.1097/SLA.0b013e3181f2aed0.
6. Dixon JB, Browne JL, Lambert GW, Jones KM, Reddy P, Pouwer F, Speight J. Severely obese people with diabetes experience impaired emotional well-being associated with socioeconomic disadvantage: results from diabetes MILES-Australia. Diabetes Res Clin Pract. 2013 Aug; 101(2):131-40. doi:10.1016/j.diabres.2013.05.017
7. Fried M, Yumuk V, Oppert J, Scopinaro N. Interdisciplinary European guidelines on metabolic and bariatric surgery/International Federation for the Surgery of Obesity and Metabolic Disorders-European Chapter(IFSOEC) and European Association for the Study of Obesity. Obes Surg. 2014 Jan;24(1):42-55. doi: 10.1007/s11695-013-1079-8.
8. Hayes K, Eid G. Laparoscopic Sleeve Gastrectomy: Surgical Technique and Perioperative Care. Surg Clin North Am. 2016 Aug;96(4):763-71. doi:10.1016/j.suc.2016.03.015.
9. Li F, Peng Y, Zhang M. Sleeve gastrectomy activates the GLP-1 pathway in pancreatic β cells and promotes GLP-1-expressing cells differentiation in the intestinal tract. Mol. Cell Endocrinol. 2016 Nov 15; 436:33-40. doi:10.1016/j.mce.2016.07.019.
Published
2018-12-28
Section
General Problems of Surgery