04 Apr Sleeve-IT Surgery Achieves Glycemic Control in Mildly Obese Diabetic Patients

MedicalResearch.com Interview with:
Ana Priscila Soggia
Sirio Libanes Hospital, São Paulo, Brazil

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For many years, bariatric surgery is performed to treat class II and III obesity with diabetes remission in 80-90% of cases, related to weight loss and change in the secretion of intestinal factors that control blood glucose, like GLP-1 and GIP.

In 2010, the International Diabetes Federation (IDF), proposed that diabetic patients with BMI between 30-35kg/m2 could be eligible, for bariatric surgery, in the case of no glycemic control with drug treatment. In this context, once glycemic control after bariatric surgery, was not related only to weight loss and also due to intestinal factors with physiological actions, the protocol was proposed.

The objectives were to compare the clinical and surgical treatment in diabetics patients with class I obesity; and to compare the efficacy and security between two different surgical techniques.

This study was developed and conducted by a research team from Sirio-Libanês Hospital in partnership with Ministry of Health through its philanthropic program PROADI. It is a clinical trial, with 42 class I obese diabetic type 2 patients with inadequate glycemic control that were randomized to tree arms: clinical treatment, gastric bypass surgery or sleeve with ileal transposition (sleeve-IT) surgery.

The results showed that the sleeve-IT procedure is more effective for the treatment of diabetes in these patients compared with treatment with medication and with bypass surgery, currently considered the first choice of treatment. Among patients who underwent sleeve-IT, 100% achieved glycemic control after 1 year (HbA1c<6,5%) compared to 46% for bypass and 8% in the case of medication therapy. In addition, diabetes remission, that was defined as adequate glycemic control without any anti-diabetic medication, occured in 75% of sleeve-IT patients had versus 30% in bypass group.

 MedicalResearch.com: What should clinicians and patients take away from your report?

Response: The technique that combines sleeve gastrectomy with ileal transposition showed to be an effective and safe choice in the treatment of mild obesity diabetic patients with best glycemic results than traditional bypass technique and clinical treatment.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: The importance of this results are related to the excellent glycemic control achieved after 1 year with safety, once there is no increased risk of adverse events with these proposed technique. Although this study has a small number of patients, the results enable further protocols to evaluate this surgical technique for the treatment of diabetes.

These results could benefit millions of people who suffer from diabetes type 2. From now, it is necessary to maintain the follow up to assess the maintenance of these results for 2 and 5 years and to publish and submit these data to the evaluation of health authorities, expanding the possibilities and forms of effective treatments against the disease.

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Citation: Abstract Presented at the April 2016 ENDO Conference

Bariatric Bypass Surgery Versus Sleeve with Ileal Transposition Surgery Versus Clinical Treatment in Obese Class I Patients with Diabetes

Not Ana Priscila Soggia^*, Marcelo Salem, Ricardo Abdalla, Luciana Neves, Andre Chiodi Elias, Thais P Sickler, Erika Bezerra Parente, Carlos Basualdo, Sandra Siqueira, Amanda Claro, Natalia Ribeiro, Gabrielle Torres, Jose Antonio Marcondes, Denise Duarte Iezzi and Claudia Kalil
Sirio Libanes Hospital, São Paulo, Brazil

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on April 4, 2016 by Marie Benz MD FAAD