Evaluation of Weight Reduction, Diabetic State and Satiety Hormones After Laparoscopic Greater Curvature Plication in Morbidly Obese Diabetic Patients
Journal of Surgery
Volume 6, Issue 2, April 2018, Pages: 43-49
Received: Feb. 6, 2018;
Accepted: Feb. 24, 2018;
Published: Mar. 19, 2018
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Waleed Omar, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Mohammad Hamed, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Sabry Ahmed Mahmoud, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Hosam Elbanna, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Mahmoud Abdelnaby, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Sameh Emile, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Mohamed Anwar, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Bariatric surgery proved effective in the treatment of morbid obesity and its associated comorbidities. The aim of this study was to assess weight loss and changes in glucose homeostasis and satiety hormones and to evaluate improvement in diabetic status in morbidly obese patients with type two diabetes mellitus (T2DM) at 6 and 12 months after laparoscopic greater curvature plication (LGCP). Twenty patients with morbid obesity with T2DM were operated upon with LGCP. Weight loss was assessed by the decrease in BMI and percentage of excess weight loss at 6 and 12 months after LGCP. Fasting and postprandial blood glucose levels, HbA1c, fasting serum insulin, serum ghrelin and glucagon-like peptide 1 (GLP-1) levels were measured before and at 6 and 12 months postoperatively. The mean age of patients was 37.6 years. There was significant decrease in BMI from 45.4 to 40.1 at 6 months (p= 0.0008) and then to 36.4 at 12 month (p< 0.0001). The mean fasting blood glucose decreased significantly from 134.8 preoperatively to 120.8 at 6 months (p< 0.0001) and then to 109.5 at 12 months (p< 0.0001). The mean preoperative HbA1c declined from 6.8 before LGCO to 6.3 at 6 months (p< 0.0001) then to 5.9 at 12 months (p< 0.0001). The mean fasting insulin level decreased from 20.5 preoperatively to 17.4 at 6 months (p< 0.0001) then to 16.7 at 12 months (p< 0.0001). The mean baseline ghrelin level decreased significantly from 551.7 preoperatively to 441.5 at 6 months (p< 0.0001) then to 422.5 at 12 months (p< 0.0001). The mean GLP-1 declined from 33.7 before surgery to 33.5 at 6 months (p= 0.76) then to 33.1 at 12 months (p= 0.36). LGCP is an effective bariatric procedure that achieved satisfactory weight loss and significant improvement in the glycemic control as demonstrated by improvement in laboratory markers as serum glucose, insulin, and ghrelin hormone levels.
Sabry Ahmed Mahmoud,
Evaluation of Weight Reduction, Diabetic State and Satiety Hormones After Laparoscopic Greater Curvature Plication in Morbidly Obese Diabetic Patients, Journal of Surgery.
Vol. 6, No. 2,
2018, pp. 43-49.
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