Sleeve Gastrectomy and Its Impact on Insulin Resistance and Metabolic Health: A Cohort Study

Obesity is a prevalent metabolic disorder that significantly contributes to insulin resistance (IR), type 2 diabetes (T2DM), and metabolic syndrome. Sleeve gastrectomy has emerged as an effective surgical intervention for obesity, with potential benefits on metabolic health. This study investigates the impact of sleeve gastrectomy on serum insulin levels, IR (HOMA-IR), inflammatory markers, C-peptide, kidney function, and various biochemical parameters in diabetic and non-diabetic patients.

A prospective cohort study was conducted, involving 199 patients over 18 years old who were candidates for sleeve gastrectomy at Luqman Hakim Hospital from 2021 to 2022. Data were collected using standardized questionnaires and anthropometric measurements, and biochemical assessments were performed before surgery and 6 months postoperatively. Statistical analyses included descriptive statistics, t-tests, Mann–Whitney tests, and repeated measures analysis of variances (ANOVA).

The study included 199 patients (84.4% female) with a mean (± standard deviation (SD)) age of 39.79 ± 11.30 years. Significant reductions were observed in weight, BMI, and abdominal circumference across all patient groups. Diabetic patients showed marked improvements in fasting blood sugar, 2-h postprandial blood sugar, and glycosylated hemoglobin levels. Insulin resistance decreased significantly, as did serum insulin and C-peptide levels. Improvements in lipid profiles and inflammatory markers were also noted. Insulin use post-surgery showed a significant inverse relationship with glycemic control improvement.

Sleeve gastrectomy is a safe and effective procedure for obese patients, significantly improving insulin resistance and various obesity-associated diseases within 6 months post-surgery.