Efficacy of bariatric surgery in improving metabolic outcomes in patients with diabetes. A 24-month follow-up study from a single center in the UAE

Abstract

BackgroundOwing to its impact on weight loss, remission of diabetes mellitus and metabolic syndrome, bariatric surgery has offered hope for grossly obese individuals. In recent years, obesity has increased in the UAE and the use of bariatric surgery has increased in-line with this trend. However, data regarding bariatric surgery outcomes in diabetic Emirati people is scarce.ObjectiveTo evaluate the effect of bariatric surgery in patients with diabetes mellitus.MethodsThis is a retrospective analysis of diabetic patients treated with bariatric surgery with a minimal follow-up of 1 year and extended for some patients (21) to 2 years follow up. A total of 80 patients underwent bariatric surgery. Two surgical procedures were used; laparoscopic sleeve gastrectomy (n=53) or mini-gastric bypass between January 1, 2015, and July 20, 2017.ResultsMean baseline weight was 119.2±31.2 kg, this has significantly dropped to 100.1±23.1, 91.2±22.3, 82.3±17.5, and 81.3±15.3 kg at 3, 6, 12, and 24 months respectively, and this change was statistically significant P<0.001 at each time point. Mean baseline HbA1c was 8.6% ± 2.3% and this dropped significantly to 6.5±1.7, 5.9±1.2, 5.6±0.8, and 5.4±0.7 at 3, 6, 12, and 24 months respectively (P<0.000). In 49 (61.3%) we considered fatty liver based on ultrasound features either with or without elevation in alanine aminotransferase (ALT). We noticed a significant decrease in ALT at 3, 6, and 12 months after surgery. Furthermore, 11 patients (22.4%) showed sonographic features of improvement in fatty liver in addition to normalization of ALT.ConclusionsBariatric surgery was effective over a follow-up period of 2 years in achieving significant weight loss as well as resulting in improvements in glycemic control, blood pressure, and fatty liver.

Improvement in body composition of adult postbariatric surgery patients at one-year follow-up at a public hospital in United Arab Emirates

“…Therefore, moving beyond a weight-centric approach to define the success and the cost-benefit of BS is recommended (Unamuno, Portincasa & Frühbeck, 2019). In a sample of 80 Emirati adults with diabetes, weight loss was within the recommended success rate postoperatively (32% after two years of follow-up); however, patients also experienced significant drops in HbA1c, systolic and diastolic blood pressures, and LDL cholesterol and total cholesterol (p<0.001 for all metabolic markers) (Alnageeb et al, 2018).…”

Management of nonalcoholic fatty liver disease in the Middle East

“…There was significant reduction in mean body weight at 3, 6, 12, and 24 mo ( P < 0.001 for each time point). Of the 61.3% who had NAFLD, 22.4% showed improvement in sonographic features of hepatic steatosis with normalization of ALT[ 70 ]. In another study ( n = 27) conducted in Saudi Arabia, after 3 mo of bariatric surgery, 66.6% of the patients with preoperative steatosis (median score 2) had reduced steatosis scores postoperatively ( P = 0.025) and 68% of the patients had reduced fibrosis (median score 1) ( P = 0.012).…”