PMID- 24272885
OWN - NLM
STAT- MEDLINE
DCOM- 20150720
LR  - 20211021
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 24
IP  - 4
DP  - 2014 Apr
TI  - Efficacy of laparoscopic sleeve gastrectomy and intensive medical management in 
      obese patients with type 2 diabetes mellitus.
PG  - 529-35
LID - 10.1007/s11695-013-1114-9 [doi]
AB  - BACKGROUND: There are a dearth of studies comparing laparoscopic sleeve 
      gastrectomy (LSG) and intensive medical treatment (IMT) in obese type 2 diabetes 
      mellitus (T2DM) patients. This study compares these modalities in terms of weight 
      loss, metabolic parameters and quality of life (QOL) score. METHODS: We evaluated 
      the efficacy of LSG (n = 14) vs. IMT (n = 17) comprising of low calorie diet, 
      exenatide, metformin and if required insulin detemir in 31 obese T2DM patients 
      with BMI of 37.9 +/- 5.3kg/m(2) and target HbA1c < 7 %. The mean (+/-SD) age of the 
      patients was 49.6 +/- 11.9 years and 74 % were women. The mean duration of diabetes 
      was 8.5 +/- 6.1 years and mean HbA1c was 8.6 +/- 1.3 %. Primary end point was excess 
      body weight loss (EBWL) at the final follow-up. RESULTS: The mean duration of 
      follow-up was 12.5 +/- 5.0 (median 12) months. EBWL was 61.2 +/- 17.6 % and 
      27.4 +/- 23.6 % in LSG and IMT group respectively (p < 0.001). Glycemic outcomes 
      improved in both with mean HbA1c of 6.6 +/- 1.5 % in LSG and 7.1 +/- 1.2 % in IMT 
      group. In LSG group, there was resolution of diabetes and hypertension in 36 and 
      29 % of patients respectively while none in the IMT group. HOMA-IR, hsCRP, 
      ghrelin and leptin decreased while adiponectin increased significantly in LSG 
      compared to IMT group. QOL score improved in LSG as compared to IMT. CONCLUSIONS: 
      In obese T2DM patients, LSG is superior to IMT in terms of weight loss, 
      resolution of comorbidities and QOL score.
FAU - Palikhe, Gaurav
AU  - Palikhe G
AD  - Department of Endocrinology, Post Graduate Institute of Medical Education and 
      Research, Chandigarh, 160012, India, gauravpalikhe@hotmail.com.
FAU - Gupta, Rajesh
AU  - Gupta R
FAU - Behera, B N
AU  - Behera BN
FAU - Sachdeva, Naresh
AU  - Sachdeva N
FAU - Gangadhar, Prathosh
AU  - Gangadhar P
FAU - Bhansali, Anil
AU  - Bhansali A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin, Long-Acting)
RN  - 0 (Peptides)
RN  - 0 (Venoms)
RN  - 4FT78T86XV (Insulin Detemir)
RN  - 9100L32L2N (Metformin)
RN  - 9P1872D4OL (Exenatide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/blood/*epidemiology
MH  - Drug Therapy, Combination
MH  - Exenatide
MH  - Female
MH  - *Gastrectomy/methods
MH  - Humans
MH  - Hypertension/epidemiology
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin Detemir
MH  - Insulin, Long-Acting/therapeutic use
MH  - Laparoscopy
MH  - Male
MH  - Metformin/therapeutic use
MH  - Middle Aged
MH  - Peptides/therapeutic use
MH  - Quality of Life
MH  - Treatment Outcome
MH  - Venoms/therapeutic use
MH  - Young Adult
EDAT- 2013/11/26 06:00
MHDA- 2015/07/21 06:00
CRDT- 2013/11/26 06:00
PHST- 2013/11/26 06:00 [entrez]
PHST- 2013/11/26 06:00 [pubmed]
PHST- 2015/07/21 06:00 [medline]
AID - 10.1007/s11695-013-1114-9 [doi]
PST - ppublish
SO  - Obes Surg. 2014 Apr;24(4):529-35. doi: 10.1007/s11695-013-1114-9.