Diabetic Neuropathy Improves After Laparoscopic Diverted Sleeve Gastrectomy with Ileal Interposition:A Single Arm Electrophysiological Follow-Up Study

Abstract

Objectives: The aim of the present study was to analyze the effect of laparoscopic diverted sleeve gastrectomy with ileal transposition (DSIT) surgery on diabetic neuropathy (DN) in patients with type 2 diabetes mellitus (T2DM).Methods: This cross sectional, non-blinded, prospective, pilot study included 55 diabetic non-responders, who fail to achieve adequate glycemic control despite appropriate medical treatment. Electrophysiological tests including mo-tor and sensory nerve conduction studies (NCS), sympathetic skin response (SSR) and R-R interval analysis of patients scheduled for metabolic surgical treatments were performed pre- and postoperatively. The differences in metabolic and electrophysiological parameters were also analyzed.Results: Preoperative NCS evaluation revealed presence of polyneuropathy in 27 (49%) individuals; however, post-operative NCS values showed decreased distal conduction time in 61%, increased response amplitudes in 40% and increased conduction velocity in 57% of patients for motor nerves. As for sensory nerves, decreased distal conduction time was found in 55% and increased response amplitudes were detected in 57% of patients. In addition, significant improvements were observed in the of SSR and R-R interval analysis postoperatively.Conclusion: Beyond the improvements in metabolic parameters and BMI in our diabetic patients who underwent DSIT, we also observed improved NCS results.