Nesreen Khidir
Hamad Medical Corporation, Qatar
Title: Laparoscopic sleeve gastrectomy effect on pre-diabetic, diabetic patients with morbid obesity: A comparison between adults and adolescents
Biography
Biography: Nesreen Khidir
Abstract
Introduction: The prevalence of obesity is rising epidemically in Qatar population. Recent studies revealed that 42% of all Qataris are obese with 7.9% prevalence in adolescents. Treatment of pre-diabetes particularly in adolescent population can potentially reduce the risk of developing future diabetes.
Aim: Primary outcome: Comparing the outcomes of Laparoscopic Sleeve Gastrectomy (LSG) in adult vs. adolescent patients in terms of weight loss i.e. BMI and percentage excess loss (%EWL) at 6-12 months. The Secondary outcome: Comparing the effect on comorbidities (diabetes, pre-diabetes and obstructive sleep apnea), complications rate, patients’ post-surgery behavioral compliance and satisfaction.
Method: Analysis of retrospective data of 139 adult vs. 91 adolescent patients 6-12 months post-operatively.
Result: LSG in 139 adults vs. 91 adolescents; 77% vs. 86% were Qataris, aged 37.4±11.4 SD vs. 17±1.5 SD, pre-operative BMI: 48.4± 8.7 vs. 47.6±7.5. Post-operative outcomes at 6-12 months showed BMI: 33.48±6.9SD vs. 36.4±7.25 SD, %EWL: 66.7±26 vs. 50.5±26.8 for adolescents. Applying the American diabetes association guidelines for diagnosing and treating diabetes in both age groups revealed that about 47 vs. 32 patients were diabetic, their mean pre-operative HbA1c dropped from 8.2±1.87 SD to 6.12± 0.089 SD (P value: 0.0001) vs. pre-operative HbA1c 10.3±3.57 SD dropped to 6.2±1.158 SD (P value: 0.0142). About 67.5% vs. 57% were cured. Pre-diabetic patients 33 vs. 32, their mean pre-operative Hba1c dropped from: 5.94±0.22 SD to 5.24±0.34 SD (P value: 0.0001) vs. 5.78+0.328 to 5.28+0.329SD (P value: 0.0001). All adult prediabetes normalized their HbA1c level vs. 96.4% for adolescents. Complications occurred in both groups; (3.5% vs. 4.4%) e.g. post-operative bleeding (2 vs. 0 patients), leak (1 vs. 0), surgical site infection (1 vs. 1). One adult patient developed stenosis and had gastric bypass at a later stage. Three adolescent patients had post-LSG stenosis and managed successfully with endoscopic dilatations.
Conclusion: At 12 months operatively, LSG shows results comparable in adult and adolescent patients in terms of BMI, %EWL and complications. LSG is effective in preventing and treating diabetes and prediabetes in both age groups.