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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

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.
Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Sunderland Royal Hospital, Newcastle Upon Tyne, UK.



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.


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.


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


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

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