Background and Aims: Metabolic surgery has been proven to be effective for improving long-term outcome in patients with obesity and T2DM in Western countries. We aimed to evaluate the effects of this treatment in Japanese patients.
Methods: We enrolled Japanese patients with obesity and T2DM who underwent laparoscopic sleeve gastrectomy (LSG) in our hospital from October 2016 to November 2019. We compared changes in body weight, HbA1c, antidiabetic drugs, and various metabolic parameters from preoperative baseline and 6 months after LSG.
Results: Fifty-one patients with obesity underwent LSG; 26 had T2DM (age, 46.2±9.2 years; duration of diabetes, 9.5±7.4 years; female sex, 65.0%). Patients’ body weight, BMI and HbA1c decreased significantly (108.1±16.7 to 88.4±15.7 kg, 39.9±5.8 to 32.7±5.9 kg/m2 and 7.4±1.2 to 6.0±0.8%, respectively). The number of antidiabetic drugs significantly decreased postoperatively (2.1±1.2 to 0.6±1.0). Among them, 18 patients completely discontinued antidiabetic drugs. And all of five patients on insulin preoperatively maintained good glycemic control without insulin injections after LSG. The T2DM remission rate (HbA1c < 6.5% and no antidiabetic medications for 6 months) was 76.9%. ROC curve analysis revealed that the remission rates were low in patients with preoperative mABCD score ≤ 5 and DiaRem score ≥ 6. Dyslipidemia, hypertension and liver enzyme elevation improved significantly after LSG as well. There were no serious complications related to LSG; one patient experienced suture failure.
Conclusion: LSG for Japanese patients with obesity and T2DM improved both body weight and glycemic control, as well as other various metabolic-related diseases. Six months after LSG, the T2DM remission rate was comparable in Japanese patients to Westerns. In addition, LSG significantly reduced the amount of antidiabetic drugs, suggesting that LSG has some advantage in healthcare costs.
Y. Oe: None. T. Takase: None. K. Cho: None. A. Nakamura: None. H. Nomoto: None. H. Kameda: None. T. Atsumi: Consultant; Self; Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline plc., Pfizer Inc., UCB Japan Co. Ltd. Speaker’s Bureau; Self; AbbVie Inc., Alexion Pharmaceuticals, Inc., Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo, Eisai Co., Ltd., Eli Lilly Japan K.K., Gilead Sciences, Inc., Mitsubishi Tanabe Pharma Corporation, Otsuka Pharmaceutical Co., Ltd., Pfizer Inc., Takeda Pharmaceutical Company Limited, UCB Japan Co. Ltd. H. Miyoshi: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K.K., Novo Nordisk Inc., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd. Speaker’s Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K.K., Kowa Company, Ltd., MDS CO. LTD., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd. Other Relationship; Self; Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Kowa Company, Ltd., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd.