Sleeve Gastrectomy in Patients with Type 2 Diabetes: Anthropometric and Cardiometabolic Improvements at 1, 3, 5, 7, and 9 years—Are the Initial Benefits Sustained?

Background: No previous study assessed the outcomes of sleeve gastrectomy (SG) beyond 5 years among adult patients with type 2 diabetes (T2DM). We appraised the evolution of 20 outcomes at 1, 3, 5, 7, and 9 years. Methods: This is a retrospective study of 361 consecutive T2DM patients who underwent SG at our institution (April 2011–December 2015). Postoperative data were compared to baseline and to previous time points using paired t tests. Diabetes status was also assessed at each time point. Results: The sample consisted of 65.37% females. The mean preoperative age was 44.38 ± 9.50 years and body mass index (BMI) was 43.81 ± 6.98 kg/m². Generally, most improvements occurred in the first year and were sustained on the long term. Postoperatively, there was a significant and sustained weight reduction, amounting to a mean decrease of 9 kg/m² in BMI at year 9 and associated excess weight loss between 59%_{year 1} and 46%_{year 9}. Fasting blood glucose decreased significantly across the five time points, from 9.27 ± 4.11_preop to 7.06 ± 2.70 _{year 9} mmol/L. Mean HbA1c significantly decreased from 8.1%_preop to 6.77%_{year 9}. The prevalence of complete remission of T2DM was 20.45%, 19.44%, and 20% at 5, 7, and 9 years respectively, with significant reductions in percentages of patients using diabetes medications or insulin. Between 10% and 23% of patients experienced relapse of T2DM by 5–9 years. In comparison to baseline levels, mean blood pressure, triglycerides, high-density lipoprotein, low-density lipoprotein, total cholesterol, and hepatic enzymes levels all showed improvement in the long term. Conclusion: Patients with T2DM experienced substantial improvements in most anthropometric and cardiometabolic outcomes within the first year, and these were sustained in the long term.