Diabetic neuropathy improves after sleeve gastrectomy
In patients with poorly controlled type 2 diabetes and obesity, symptoms of diabetic neuropathy were shown to improve in the months after laparoscopic sleeve gastrectomy with ileal transposition, according to study findings presented at the European Congress of Endocrinology.
“So-called ‘irreversible’ diabetic neuropathy can be reversible,” Alper Celik, MD, medical director of the Metabolic Surgery Clinic in Istanbul, told Endocrine Today. “Diabetic neuropathy improved in almost two-thirds of the cases after metabolic surgery. This improvement occurred regardless of weight loss and glycemic regulation after surgery.”
In a cross-sectional, non-masked, prospective pilot study, Celik and Eylem Cagiltay, of GATA Haydarpasa Training and Research Hospital in Istanbul, and colleagues analyzed data from 55 patients with poorly controlled type 2 diabetes and obesity (mean diabetes duration, 13.4 years; mean HbA1c, 9.6%; mean BMI, 34 kg/m²). Patients underwent autonomic testing, including motor and sensory nerve conduction studies, sympathetic skin response and R-R interval analysis at baseline and after surgery. Researchers analyzed differences in metabolic and electrophysiologic parameters.
At a mean of 8 months after surgery, mean HbA1c fell to 6.6%; mean BMI fell to 26.1 kg/m² (P < .001 for both). Within the cohort, 27 patients (49%) showed signs of polyneuropathy before surgery. At a mean of 8 months after surgery, 61% of the 27 patients showed decreased distal conduction time in motor conduction studies; 40% showed increased response amplitudes; 57% showed increased conduction velocity. For sensory nerves, 55% of patients with polyneuropathy showed decreased distal conduction time; 55% increased response amplitudes. Researchers also observed improvements in sympathetic skin response and R-R interval analysis after surgery.
“We need to conduct research projects based on the mechanisms of improvement after metabolic surgery,” Celik said. – by Regina Schaffer
Cagiltay E, et al. Abstract OC3.5. Presented at: European Congress of Endocrinology; May 28-31, 2016; Munich.
Disclosure: Cagiltay and Celik report no relevant financial disclosures.