NEW DELHI: It is not just the severely obese people who have uncontrolled diabetes. Even those with mild obesity– BMI ranging between 30 kg/m2 to 34.9 kg/m2 – and uncontrolled diabetes can benefit from weight loss surgery.
The bariatric surgery unit of AIIMS has claimed this on the basis of a study that involved follow-up of 17 patients who underwent sleeve gastrectomy — surgical procedure to remove a portion of the stomach — for diabetes management. At the end of a five-year follow-up, the study published recently in Obesity Surgery, a reputed medical journal, states that nine (53%) out of 17 patients had diabetes under control without any medication while seven (41%) others who were earlier on multiple medication for diabetes were doing well with only one medication. One patient had recurrence of diabetes after initial remission, it adds.
According to Dr Sandeep Aggarwal, the lead author of the study, none of the patients is requiring insulin now. “Weight loss surgery is a widely accepted treatment for diabetes management in severely obese patients. But here in this study, we have shown that even mildly obese patients can benefit from it,” Dr Aggarwal said.
The AIIMS surgeons used sleeve gastrectomy, a simpler procedure as compared to gastric bypass for weight loss. It involves removing a portion of the stomach unlike the gastric bypass surgery, which also involves alteration of intestinal anatomy.
Dr Aggarwal, a professor and head of bariatric surgery at AIIMS, said sleeve gastrectomy was easier to perform and had less risks. “It is known to cause significant improvement of glycaemic status in the short term. In the immediate postoperative period, even before any significant weight loss, improvement in plasma glucose levels occur because of increased insulin sensitivity and improved beta cell function, leading to marked improvement in the early phase of insulin release, which is usually defective in patients with type 2 diabetes,” he explained. The study shows the benefits are sustained over longer periods, he added. The doctor, however, stressed the need to conduct larger sample size and longer follow-up studies to further establish the benefits of sleeve gastrectomy for diabetes management.
Dr Anoop Misra, chairman, Fortis C-Doc, said weight loss surgery was known to benefit patients who were severely obese and had uncontrolled diabetes. “I have seen patients who were saved due to timely surgery,” he said.