Session: SAT 660-676-Clinical Obesity Treatment
Poster Board SAT-669
Methods: Forty six patients underwent II + SG and 29 for II + DSG. MSAS was calculated based on preoperative baseline parameters like age, body mass index, duration of diabetes, associated micro or macro vascular complications, meal stimulated C-Peptide levels and mandatory insulin usage to control their diabetes. Remission in diabetes was defined as maintaining HbA1C < 6.5% without any medication. MSAS of the subjects with and without remission were compared.
Results: Patients subjected to II+SG had mean age of 48.3 ± 8.1 years, mean duration of diabetes was 9.8 ± 7.6 years and had mean BMI of 32.1 ± 6.9 Kg/m2. All patients had poorly controlled diabetes with mean base line HbA1C 9.5 ± 2.2 %. Mean MSAS in patients who underwent II + SG (n=46) was 9.2 ±1.4. Twenty one (46%) had remission in diabetes. MSAS was significantly lower in patients with remission than patients without remission (8.1±0.8 versus 10.2 ±0.9, p<0.0001). Patients with BMI ≥ 35 kg/m2 had remission in 85% of patients. Their mean MSAS was 8.9 ± 1.7 versus mean MSAS of 9.5 ± 1.1 in patients with BMI less than 35 (p = 0.07).
Patients subjected to II+DSG had mean age of 48.7 ± 7.8 years, DM duration of 13.1 ± 5.8 years and BMI 29.1 ± 6.7 Kg/m2. All patients had poorly controlled diabetes with HbA1C 9.8 ± 1.8 %. Mean MSAS in patients who underwent II + DSG (n=29) was 10.4±1.3 (significantly higher than II+SG group, p = 0.0004). Twenty one (72%) had remission in diabetes. MSAS was significantly lower in patients with remission than patients without remission (9.7±0.8 versus 12.0 ±0.5, p<0.0001).
Patients with MSAS ≥ 10 in II+SG group and MSAS ≥ 12 in II+DSG group did not get remission. MSAS was not significantly different (p = 0.1468) in patients without remission in II+SG (10.2 ±0.9) versus patients with remission in II+DSG (9.7±0.8). This indirectly suggests that DSG instead of SG would have helped them in achieving remission.
Conclusion: Preoperative MSAS can be a useful tool to select the type of surgical procedure and to predict the post operative diabetes remission.
Nothing to Disclose: KDM, SKK Sr., SU, NG
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