Abstract

Background: Type-2 diabetes mellitus (T2DM) keeps increasing worldwide. Of the many options available surgically to treat diabetes, the Sleeve Plus group appears to have good results. One such procedure, the Jejunal Ileal Interposition with sleeve gastrectomy (J-IISG) has been assessed here for its long term outcomes up to 10 years, on diabetes and weight control, a big advantage being that there is no bowel exclusion ( no bypass).

Methods: Retrospective study and analysis of prospectively collected data of 72 patients who underwent J-IISG, for T2DM, since 2008, having mean age of 46.5 years, mean Body Mass Index (BMI) of 34.5 kg/m², duration of diabetes mellitus (DM) being 9 years, fasting C-peptide of 3.18ng/ml and mean glycosylated hemoglobin (HbA1c, A1c) of 8.9%. 54% of patients were on insulin.

Results: Follow-up at 10 years was 63.8%, with remission of diabetes of 67% up to 3 years, 57% at 5 years, and 43% of patients at 10 years maintained A1c ≤ 6.5%. Percentage of total weight loss was 21.3% at 5 years with mean BMI of 25.6, whereas % TWL at 10 years was 16.5% with mean BMI of 27. Patients exhibited good nutritional stability even at 10 years.

Conclusion: Jejunal ileal interposition with sleeve gastrectomy is a very good option to achieve good long term results with nutritional stability, without bypassing any bowel.

Keywords: Type-2 Diabetes; Low BMI; Glycemic Control; Ileal Interposition; Nutritional Stability; 10 Year Results

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