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J Minim Access Surg. 2019 Jan 4. doi: 10.4103/jmas.JMAS_219_18. [Epub ahead of print]

Early outcome of bariatric surgery for the treatment of type 2 diabetes mellitus in super-obese Malaysian population.

Author information

1
Department of Surgery, Faculty of Medicine, Minimally Invasive, Upper GI and Bariatric Surgery Unit, Pusat Perubatan Universiti Kebangsaan Malaysia, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
2
Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
3
Sunderland Royal Hospital, Newcastle Upon Tyne, UK.

Abstract

Introduction:

Despite many challenges, the benefit of bariatric surgery in super-obese population remains irrefutable with significant improvement in metabolic syndrome and quality of life. There are currently no published data from Malaysia on this topic.

Objective and Methodology:

A single-centre retrospective study aimed at analysing the outcome of laparoscopic bariatric surgery on super-obese Malaysians with type 2 diabetes mellitus (T2DM) at 12 months following surgery. Demographic details, glycaemic control and weight-loss parameters were analysed. P < 0.01 was considered statistically significant.

Results:

Of the 33 patients, 55% were women and 45% were men with a mean age of 40 ± 11 years and body mass index (BMI) of 59.3 ± 9.0 kg/m2. Majority of patients were of Malay ethnicity (82%). Malaysian-Indians and Malaysian-Chinese each accounted for 9% of total case volume. The three types of laparoscopic bariatric surgery recorded in this study were sleeve gastrectomy (82%), Roux-en-Y gastric bypass (9%) and mini-gastric bypass (9%) with operative time of 103.5 ± 31.1, 135.8 ± 32.6 and 116.2 ± 32.3 min, respectively. Percentage total body weight loss was 33.11% ± 9.44% at 12 months following surgery (P < 0.01). BMI change and percentage excess BMI loss showed similar improvement. Glycosylated haemoglobin and fasting blood sugar decreased from pre-operative values of 7.0% ± 1.0% and 7.0 ± 0.9 mmol/L to 5.6% ± 0.4% and 5.0 ± 0.6 mmol/L at 12 months (P < 0.01). Remission of T2DM was noted in 93% of patients. There was no correlation between weight loss and improvement in glycaemic status.

Conclusion:

There are significant weight loss and improvement of glycaemic control at 12 months post-laparoscopic bariatric surgery among super-obese Malaysians.

KEYWORDS:

Bariatric surgery; glycosylated haemoglobin; metabolic syndrome; obesity; type 2 diabetes mellitus

PMID:
30618425
DOI:
10.4103/jmas.JMAS_219_18
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