Efficacy and safety of single-anastomosis duodenal-ileal bypass with sleeve gastrectomy for the treatment of Chinese T2D patients with obesity

Abstract

Background: Bariatric surgery is the most effective treatment for obese T2D. As one of the most effective bariatric surgeries, SADI-S was recently introduced in China, and there is limited evidence of its efficacy and safety in the treatment of obese T2D. The aim of this study is to investigate the safety and efficacy of SADI-S in the treatment of obese T2D in China. Methods: The clinical data of 32 obese T2D patients who underwent SADI-S was included in this study. Changes in weight-related indicators, diabetes-related indicators, and patient nutritional outcomes were analyzed. Results: SADI-S was conducted successfully in all of the 32 cases without conversion to laparotomy or death. The incidence of surgical complications was 15.6% (5/32). The major complication rate was 6.3% (2/32). At 1 year after surgery, the BMI (kg/m2) significantly decreased from 40.8 ± 7.4 to 23.9 ± 2.9 (P < 0.05) and the mean HbA1c significantly decreased from 8.5% (6.4–11.5) to 5.0% (3.8–5.6) (P < 0.05). At 2 years after surgery, the BMI (kg/m2) significantly decreased to 24.9 ± 2.4 (P < 0.05) and the mean HbA1c significantly decreased to (4.8 ± 0.4)% (P < 0.05). The %TWL was (40.4 ± 6.5)% and (42.9 ± 4.9)% at 1 year and 2 years, respectively. The complete remission rates for T2D were both 100% at 1 year and 2 years. Triglyceride levels were significantly improved compared with preoperative, from (3.2 ± 3.0) mmol/L to (1.0 ± 0.3) mmol/L (P < 0.05), but there was no significant difference in other nutritional outcomes. Conclusion: The SADI-S has excellent curative effect in the treatment of Chinese obese T2D, but the operation is challenging and the complication rate is high. Its long-term efficacy and safety require further study.

Keywords

• Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S)
• Type 2 diabetes
• Obesity
• Metabolic surgery
• Safety