Peri-Operative Glycemic Dynamics in a Chinese Patient With Type 2 Diabetes Undergoing Laparoscopic Sleeve Gastrectomy

Abstract

Obesity and type 2 diabetes (T2D) are prevalent issues in China. Bariatric and metabolic surgery, by reducing the size of the stomach through the removal of a portion of the stomach using laparoscopy (laparoscopic sleeve gastrectomy (LSG)), induces the remarkable remission of T2D inpatients. Plasma glucose (PG) was reported to be at a lower than normal level in Caucasian patients a few weeks after surgery, which is not well-documented in Chinese patients who have a lower body mass index (BMI) compared to Caucasians. Thus, we adopted the use of a continuous glucose monitoring system (CGMS) in a Chinese patient to monitor postoperative glucose levels. We found that the level of PG lowered to the normal range four days after LSG surgery while weight loss was not significantly reduced. It is indicated that the main mechanism of LSG inducing remission of T2DM is the limitation of food intake in addition to the imbalance of a few gastrointestinal hormones such as glucagon-like peptide 1 (GLP-1), Ghrelin. The lower the BMI, the lower the adipose tissue, and the faster the decrease in PG after bariatric and metabolic surgery.