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Bariatric surgery in the treatment of obesity - reports from Dubrava University Hospital

Objectives: To assess the effect of bariatric surgery (sleeve gastrectomy) in obese subjects over 12 months postoperative period. Materials and Methods: We report three obese patients (two women and one man), with an average age of 42, 6 years and body mass index of >40 kg/m2. Two of them had poorly regulated diabetes mellitus, glycated hemoglobin levels (HbA1c) >7, 5% (one patient with metabolic syndrome, glycated hemoglobin level 8, 3% and taking metformin and liraglutide ; the other patient with glycated hemoglobin level 7, 7% and using metformin) and a third patient without obesity related metabolic complications. Results: The subjects lost an average of 46 kg during one year. In both patients with poorly regulated diabetes, the decrease in glycated hemoglobin level 12 months after surgery was 2%. The patient with type 2 diabetes lost 70 kilograms, has followed diabetes diet plan and metformin was discontinued from therapy. The subject with metabolic syndrome lost only 21 kilograms, did not follow diabetes diet plan and was introduced with naltrexone/bupropion. The patient without obesity related metabolic complications lost 57 kilograms, but refused to change her poor dietary habits after the surgery. Conclusion: Numerous clinical trials have confirmed that bariatric surgery is one of the most effective methods in the treatment of obesity. Surgical interventions that change the anatomic relations in the digestive tract may affect mechanisms that regulate plasma glucose levels. The specificity of treating obesity depends largely on the patient's persistence. There is no single drug or surgical procedure that solves all of the problems and lifestyle and diet changes are also needed.

bariatric surgery (sleeve gastrectomy) ; obese patients ; regulate plasma glucose levels

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