The effect of Laparoscopic Sleeve Gastrectomy (LSG) on glycemic control in morbidly obese patients

Abstract Introduction Bariatric procedures have become popular in treating not only the morbid obesity but also the metabolic derangements. Sleeve Gastrectomy has recently become popular as a standalone procedure and its usefulness as a metabolic procedure especially glycemic control is still under investigation. One of the most commonly used measure of insulin resistance is statistically derived ‘Homeostatic model assessment of insulin resistance (HOMA-IR). Aim The effect of Laparoscopic Sleeve Gastrectomy (LSG) on clinical and measurable change in glycemic control as seen by reduction of insulin resistance ie HOMA-IR levels in morbidly obese patients. Material and methods All the patients with BMI ≥ 35 kg/m2 with co morbidities and BMI ≥ 40 kg/m2 even without co morbidities were included in the study. The period of the study was from Feb 2013 to Sep 2014. Fasting (FBS), post prandial blood sugar (PPBS) and Insulin levels were checked before the surgery, 1month and 3 month after the surgery. We also recorded BMI and diabetic status. HOMA-IR was calculated and trends were recorded. Statistical analysis Statistical analysis was carried out using SPSS 16.0. Results Out of 28 patients 8 were males and 20 were females. The mean age was 43 yrs. 11 (39%) patients were diabetic and mean BMI was 44 kg/m2 and a range of (35-61.3) kg/m2. 11 patients had BMI>45kg/m2. The HOMA-IR values decreased significantly after the surgery both in diabetics and non diabetics. Conclusion LSG results in improvement in glycemic control in both diabetics and non diabetics.