Analysis Of The Mid-term Effect Of Laparoscopic Sleeve Gastrectomy On Type 2 Diabetes Mellitus

Objective:To analyze the mid-term effect of laparoscopic sleeve gastrectomy(LSG)on type 2 diabetes mellitus(T2DM).Methods:The clinical data of 42 patients with T2DM who were treated with LSG in the Weight Loss and Metabolism Surgery Department of Bethune Third Hospital of Jilin University from August 2014 to December 2019were analyzed retrospectively.To study the mid-term effect of LSG on T2DM;To analyze the influence of body mass index(BMI),C-peptide,diabetes course,ABCD score and percentage total weight loss(%TWL)on the medium-term efficacy of T2DM;According to the curative effect of T2DM,the patients were divided into complete remission group and incomplete remission group,and the differences between the two groups were compared.Results:The body weight,BMI and waist circumference after LSG were significantly lower than those before LSG,and the difference was statistically significant(P<0.05);The%TWL after LSG was(21.40±6.83)%,and the percentage excess weight loss(%EWL)was(127.24±136.26)%;Postoperative fasting blood glucose and glycosylated hemoglobin decreased significantly compared with preoperative indexes,the difference was statistically significant(P<0.05);After operation,the complete remission rate of T2DM was 35.71%,the partial remission rate was 21.43%,the significant improvement rate was 7.14%,the ineffective rate was 35.71%,and the effective rate was 64.29%;The greater the preoperative BMI value,the higher the C-peptide level,the shorter the duration of diabetes,the higher the ABCD score,and the greater the postoperative%TWL value,the better the T2DM efficacy;Compared with the incomplete remission group,the preoperative age and duration of diabetes in the complete remission group were significantly lower than those in the incomplete remission group(P<0.05),and the fasting insulin,fasting C-peptide,weight,BMI,waist circumference and ABCD scores in the complete remission group were significantly higher than those in the incomplete remission group(P<0.05).Conclusion:LSG has a good mid-term effect on T2DM and is an effective surgical method for obesity and T2DM.However,the mid-term effect of LSG on T2DM is weaker than the short-term effect.With the extension of follow-up time after operation,there is a possibility of recurrence of T2DM.Patients with%TWL<20%have a poor effect on T2DM.Long-term follow-up is required after operation.Patients need to change their poor lifestyle and diet to maintain adequate weight loss,so as to improve the effect of T2DM.Patients should be carefully selected before operation,and preoperative BMI,C-peptide,T2DM course and ABCD score can be used as important indicators to predict the prognosis of T2DM.For patients with BMI<30 kg/m~2,C-peptide<2nmol/L,diabetes duration over 10 years,and ABCD score≤3,T2DM has poor efficacy,and LSG should be used cautiously.