Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score.

Background Laparoscopic sleeve gastrectomy (LSG) is becoming a primary bariatric surgery for obesity and related diseases. This study presents the outcome of LSG with regard to the remission of type 2 diabetes mellitus (T2 DM) and the usefulness of a grading system to categorize and predict outcome of T2 DM remission. Methods A total of 157 patients with T2 DM (82 women and 75 men) with morbid obesity (mean body mass index 39.0±7.4 kg/m 2 ) who underwent LSG from 2006 to 2013 were selected for the present study. The ABCD score is composed of the patient’s age, body mass index, C-peptide level, and duration of T2 DM (yr). The remission of T2 DM after LSG was evaluated using the ABCD score. Results At 12 months after surgery, 85 of the patients had complete follow-up data. The weight loss was 26.5% and the mean HbA 1c decreased from 8.1% to 6.1%. A significant number of patients had improvement in their glycemic control, including 45 (52.9%) patients who had complete remission (HbA 1c <6.0%), another 18 (21.2%) who had partial remission (HbA 1c <6.5%), and 9 (10.6%) who improved (HbA 1c <7%). Patients who had T2 DM remission after surgery had a higher ABCD score than those who did not (7.3±1.7 versus 5.2±2.1, P <.05). Patients with a higher ABCD score were also at a higher rate of success in T2 DM remission (from 0% in score 0 to 100% in score 10). Conclusion LSG is an effective and well-tolerated procedure for achieving weight loss and T2 DM remission. The ABCD score, a simple multidimensional grading system, can predict the success of T2 DM treatment by LSG. [ABSTRACT FROM AUTHOR]