IDDF2022-ABS-0026 Role of endoscopic sleeve gastroplasty in diabesity – a single-center experience

Background

Type 2 diabetes mellitus (T2DM) is a major disease burden in India. The prevalence of obesity in T2DM is 60 – 90%. Endoscopic sleeve gastroplasty (ESG) is an incisionless, minimally invasive bariatric procedure to facilitate weight loss. We performed a prospective study to evaluate the effects of ESG on total body weight loss (TBWL) and glycemic control in T2DM obese individuals.

Methods

In this single-center prospective observational study, consecutive patients with a BMI of more than 27.5 kg/m² with T2DM, who underwent ESG were enrolled between January 2021 and August 2021. The primary outcome was to study the impact of ESG on weight, BMI and HbA1c in these patients. The baseline and 6 months follow-up data were compared using paired t-tests.

Results

A total of 30 T2DM obese patients underwent ESG of which 14 were males and 16 females. The mean age was 47 ± 6.78 years. Their mean (SD) weight, BMI, and HbA1c at baseline were 99.59 ± 26.1 kgs, 36.07 ± 5.77 kg/m², and 8.63 ± 1.43%, respectively. At 6 months, there was TBWL of 10.11 ± 0.84 kgs (p 0.0001); corresponding to change in BMI by 3.74 ± 0.11 kg/m² (p = 0.0001) and reduction in HbA1c by 1.25 ± 0.05% (p = 0.001). There was significantly greater reduction in weight and BMI at 6 months in males compared to females (11.88 ± 0.17 kgs vs. 8.56 ± 1.52 kgs, p = 0.0001; 4.03 ± 0.25 kg/m² vs. 3.49 ± 0.75 kg/m², p = 0.0159) as males had higher baseline weight and BMI. Females had a greater reduction in HbA1c at 6 months compared to males (1.41 ± 0.26% vs. 1.07 ± 0.155, p = 0.0002) as they had higher baseline HbA1c. Additionally, 5 (16.6%) patients were off oral hypoglycemic agents (OHA’s) at 6 months and in 17 (56.6%) patients there was a reduction in exogenous insulin requirement. There was no major adverse event.

Conclusions

ESG is a safe and effective endoscopic procedure that reduces weight and improves glycemic control in obese individuals.