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Analysis of quality of life in patients with clinically severe obesity and type 2 diabetes mellitus after laparoscopic sleeve gastrectomy – a 12-month prospective observational study

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Wysocki M., Mizera M., Karpińska I., Ptaszkiewicz K., Małczak P., Pisarska-Adamczyk M., Kania M., Major P.

Polish Journal of Surgery

2024

vol. 96

issue 6

20-30

Introduction: Due to a short history of laparoscopic sleeve gastrectomy (LSG) as an independent bariatric procedure, we still lack studies providing analysis of the quality of life (QoL) in patients with type 2 diabetes mellitus (DM2). Aim: We aimed to assess the influence of LSG on QoL in obese patients with DM2. Material and Methods: Prospective, observational study included patients with: morbid obesity, body mass index (BMI) ≥ 35 kg/m² and ≤ 50 kg/m2, DM2 shorter than 10 years, qualified for LSG. Bariatric Analysis and Reporting Outcome System (BAROS) that included the Moorehead-Ardelt Quality of Life Questionnaire II (MA-QoLQII) score, and the SF-36 Health Survey (SF-36) questionnaire were used for repetitive assessment of QoL before LSG and after one and 12 months following surgery. Selected clinical and biochemical parameters were also repeatedly measured. Results: Thirty-three patients were included in the study (23 females). Patients’ mean age was 45 ±10 years. BAROS significantly increased before LSG, one month, and one year after surgery (0.63 ±1.12, 2.94 ±1.90, and 4.97 ±2.08, respectively). The MA-QoLQII score significantly rose with an increase of excess body mass index loss (EBMIL) (P = 0.002) and remission of DM2 (P = 0.049), while inversely correlated with Homeostatic Model Assessment for Insulin Resistance index (HOMA-IR) (P = 0.003). Degenerative joint disease (P = 0.025) and average time of low glucose concentration in continuous glucose monitoring (CGM) (P = 0.005) had an inverse correlation with SF-36 Physical Component Summaries (PCS), standardized for cardiovascular comorbidity, EBMIL and HOMA-IR (P = 0.839; P = 0.086; P = 0.571, respectively). EBMIL (P = 0.003), remission of DM2 (P < 0.001) had a positive correlation with Mental Component Summaries (MCS), while HOMA-IR (P < 0.001) and count of low glucose concentration events (P = 0.022) had an inverse correlation with MCS, while standardized for average glucose concentration in CGM after 12 months (P = 0.586). Discussion: Significant improvement in QoL was observed in patients with DM2 after LSG. Remission of DM2, higher EBMIL, lower HOMA-IR, fewer and shorter low glucose concentration events in CGM after 12 months were factors that increased selected QoL scores.

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1 Polish Journal of Surgery

1 2024

1 Kania M.

1 Karpińska I.

1 Major P.

1 Małczak P.

1 Mizera M.

1 Pisarska-Adamczyk M.

1 Ptaszkiewicz K.

1 Wysocki M.

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Analysis of quality of life in patients with clinically severe obesity and type 2 diabetes mellitus after laparoscopic sleeve gastrectomy – a 12-month prospective observational study