Re-emergence of Diabetes After Sleeve Gastrectomy in Patients with Long-Term Follow-up

Data about relapse of type 2 diabetes mellitus (T2D) after bariatric surgery remains scarce. In addition, most of the reports referring to this issue stand on gastric bypass (GBP) and very little information can be collected about T2D relapse after laparoscopic sleeve gastrectomy (LSG) which is one of the most popular bariatric procedures nowadays. To determine the incidence of durable remission of T2D after sleeve gastrectomy and factors associated with T2D relapse. A case series analysis of all patients with T2D who had undergone primary LSG from the year 2008 where both the hospital records and data on follow-up visit has been studied and carefully included was performed in the present study. At baseline (T1), preoperative characteristics were assessed by descriptive statistics. Outcomes were evaluated in the first year postoperative (T2) and at the most recent control (T3). Between June 2006 and December 2010, 47 patients underwent LSG at our Institution. After the operation (T2), all patients showed rapid improvement in their T2D; 79% achieved complete remission and 21% registered an improvement in their metabolic control. At T3, the average follow-up time was 8.8 years (7.7–12 years) and 54% of the patients with initial T2D control after surgery experienced relapse. T2D results were compared between patients with adequate weight loss maintenance (n = 25) versus those with inadequate weight loss maintenance at T3 (n = 22). Remission or improvement was significantly greater within the first group (p ˂ 0.02). Sleeve gastrectomy significantly improved diabetes control and appeared to improve the trajectory of the disease even after 8 years.