Association of Sleeve Gastrectomy With Glycemic Control in Jordanian Adults With Type 2 Diabetes Mellitus and Dysglycemia
In a retrospective cohort study of Jordanian adults with type 2 diabetes and dysglycemia, sleeve gastrectomy was associated with significantly better glycemic control, greater BMI reduction, and fewer new microvascular complications compared to non-surgical medical management.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Type 2 diabetes is a condition where the body struggles to manage the sugar in the blood, often leading to serious damage to the eyes, kidneys, and nerves over time. For many people, this struggle is closely tied to excess weight, which makes the body's natural insulin less effective. While doctors have long relied on diet changes and medication to lower blood sugar levels, these methods do not work for everyone, and the disease often continues to progress. In recent years, a surgical procedure called sleeve gastrectomy has emerged as a powerful alternative. This operation involves removing a large portion of the stomach, leaving a narrow tube that holds much less food. While it was originally designed to help people lose weight, doctors have noticed that it often leads to a dramatic improvement in blood sugar control, sometimes even reversing the disease entirely. However, most of the research on this surgery has come from Western countries, leaving a gap in knowledge about how it works for people in the Middle East, where the patterns of diabetes and obesity can differ.
Researchers in Jordan set out to fill this gap by looking at the real-world results of this surgery for adults living with type 2 diabetes and related blood sugar issues. They gathered information from the medical records of 239 adults treated at a major hospital in Amman. These patients were split into two groups based on how they were treated: 65 people underwent the sleeve gastrectomy surgery, while 174 people continued with standard medical management, which included diet advice, exercise, and various medications. The team compared the two groups over a period of roughly two years, tracking how their body mass index changed, how well their blood sugar was controlled, and whether they developed new complications affecting their eyes, kidneys, or nerves.
The results showed a clear difference between the two paths. The patients who had the surgery experienced a significant drop in their body mass index, losing an average of 10.9 units, while the group that stayed on medical treatment actually saw their body mass index rise slightly by an average of 1.3 units. More importantly, the surgery group achieved much better control over their blood sugar. When the researchers looked at the most recent blood sugar test results, the median level for the surgical group was 5.2 percent, a healthy range, whereas the medical group averaged 7.5 percent. The difference was even more striking when looking at who reached the specific target of having a blood sugar level below 6.5 percent. Nearly all of the surgical patients, about 97 percent, reached this goal, compared to only about one-quarter of the patients who were treated with medication alone.
Even after the researchers adjusted for differences between the groups—such as the fact that the surgical patients were generally younger, had a higher starting weight, and had been living with diabetes for a shorter time—the surgery remained a strong predictor of success. The data indicated that patients who underwent the procedure were nearly five times more likely to achieve good blood sugar control than those who did not. The study also looked at the development of new complications. In the group that received only medical treatment, about 16 percent of patients developed new damage to their eyes, kidneys, or nerves during the study period. In contrast, only about 5 percent of the surgical group developed these new issues. While the researchers noted that this difference in complications should be viewed with some caution due to the nature of the study, the trend suggests that the surgery may help protect against long-term damage.
This study provides a clear picture of how sleeve gastrectomy performs for adults in Jordan, showing that it is associated with substantial weight loss and a much higher chance of bringing blood sugar levels back to a healthy range compared to standard medical care. The findings suggest that for patients with obesity and type 2 diabetes, this surgical option can be a highly effective way to manage the disease and potentially prevent the serious complications that often follow. However, because this was a look back at past records rather than a new experiment where patients were randomly assigned to groups, the results show a strong association rather than absolute proof of cause and effect. The researchers emphasize that while the outcomes are promising, future studies with longer follow-up periods will be needed to confirm how long these benefits last and to fully understand the long-term impact on health.
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