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Surg Obes Relat Dis. 2015 Sep-Oct;11(5):991-6. doi: 10.1016/j.soard.2014.12.027. Epub 2014 Dec 31.

Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score.

Author information

1
Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China. Electronic address: wjlee_obessurg_tw@yahoo.com.tw.
2
Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China.
3
Department of International Business, Chien Hsin University of Science and Technology, Taoyuan, Taiwan, Republic of China.

Abstract

BACKGROUND:

Laparoscopic sleeve gastrectomy (LSG) is becoming a primary bariatric surgery for obesity and related diseases. This study presents the outcome of LSG with regard to the remission of type 2 diabetes mellitus (T2 DM) and the usefulness of a grading system to categorize and predict outcome of T2 DM remission.

METHODS:

A total of 157 patients with T2 DM (82 women and 75 men) with morbid obesity (mean body mass index 39.0±7.4 kg/m(2)) who underwent LSG from 2006 to 2013 were selected for the present study. The ABCD score is composed of the patient's age, body mass index, C-peptide level, and duration of T2 DM (yr). The remission of T2 DM after LSG was evaluated using the ABCD score.

RESULTS:

At 12 months after surgery, 85 of the patients had complete follow-up data. The weight loss was 26.5% and the mean HbA1c decreased from 8.1% to 6.1%. A significant number of patients had improvement in their glycemic control, including 45 (52.9%) patients who had complete remission (HbA1c<6.0%), another 18 (21.2%) who had partial remission (HbA1c<6.5%), and 9 (10.6%) who improved (HbA1c<7%). Patients who had T2 DM remission after surgery had a higher ABCD score than those who did not (7.3±1.7 versus 5.2±2.1, P<.05). Patients with a higher ABCD score were also at a higher rate of success in T2 DM remission (from 0% in score 0 to 100% in score 10).

CONCLUSION:

LSG is an effective and well-tolerated procedure for achieving weight loss and T2 DM remission. The ABCD score, a simple multidimensional grading system, can predict the success of T2 DM treatment by LSG.

KEYWORDS:

ABCD score; Sleeve gastrectomy; Type 2 diabetes mellitus

PMID:
25868836
DOI:
10.1016/j.soard.2014.12.027
[Indexed for MEDLINE]

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