Abstract
BACKGROUND: There is limited evidence on the efficacy and safety of single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) in treating type 2 diabetes mellitus (T2DM) in patients with body mass index (BMI) < 35 kg/m(2). METHODS: This study included clinical data from 22 T2DM patients with BMI < 35 kg/m(2) who received SADI-S treatment. Changes in diabetes-related indicators, weight-related indicators, and patient nutritional outcomes were analyzed. RESULTS: SADI-S was successfully performed in all 22 cases, with no conversions to laparotomy or resulting deaths. The incidence of surgical complications was 4.54% (1/22). One-year postsurgery, there was a significant decrease in BMI from 32.42 ± 2.18 to 22.11 ± 1.86 kg/m(2) (P < 0.05) and a significant decrease in mean HbA1c from 8.76 ± 1.74 to 5.25 ± 0.76% (P < 0.05). The %EWL and %TWL were 145.78 ± 35.97% and 31.60 ± 6.34% respectively at 1 year. The remission rate for T2DM was 94.7% (18/19) at 1 year. Following SADI-S, the incidence rates of zinc deficiency and vitamin D deficiency at 1 year were 38.46% (5/13) and 30.77% (4/13), respectively, significantly higher than presurgery. CONCLUSIONS: SADI-S is considered an efficient, safe, and feasible surgical approach for patients with T2DM and a BMI < 35 kg/m(2). Nevertheless, additional research, including potentially multi-center collaborative studies, is warranted to assess the procedure's long-term outcomes.