الفهرس 
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Abstract
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight by the square of the person’s height, is over 30 kg/m2, with the range 25–30 kg/m2 defined as overweight.
Obesity increases the likelihood of various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, osteoarthritis and depression.
Reducing body weight in overweight and obese patients not only helps reduce the risk of these comorbidities from developing but also helps in their management. Effective weight control involves multiple techniques and strategies including dietary, physical, behavioural therapies, also pharmacotherapy and surgery as well as combinations of these strategies.
Medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success. the
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only effective long-term method for weight loss has been shown to be bariatric surgery.
Bariatric surgical procedure reduce caloric intake by modifying the anatomy of the gastrointestinal tract, these operations are classified as either restrictive or malabsorptive.
Sleeve gastrectomy is a surgical weight-loss procedure. This procedure is typically performed laparoscopically, During sleeve gastrectomy, about 80 percent of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana.
Limiting the size of your stomach restricts the amount of food you are able to consume. In addition, the procedure prompts hormonal changes that assist with weight loss and help relieve conditions associated with being overweight, such as high blood pressure or heart disease and T2DM.
Bariatric surgery has therefore recently been recommended as part of the diabetes treatment with body mass index (BMI) below 35 kg/m2. The observed effects on glucose control are rapid and obviously in part non-weight dependent .
The mechanism of T2DM resolution after LSG is related to incretins, especially glucagon-like peptide-1 (GLP-1), it has been postulated that a chronic increase in the production of
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GLP-1 might result in an increase in β-cell mass and peptide YY (PYY) and can accelerate gastric emptying. In addition, LSG resulted in significantly decreased levels of ghrelin because of the resection of the ghrelin-producing gastric fundus which results in mitigation of appetite and weight reduction .
Obesity, especially central obesity, is known to be associated with insulin resistance, glucose intolerance, and T2DM. Therefore, it was found that C-peptide was commonly elevated and 58.0% of the morbidly obese surgical patients with T2DM showed abnormally high levels. The C-peptide level was found to be consistently elevated with an increasing BMI.
The elevated C-peptide was a common finding in morbidly obese surgical patients. The elevated C-peptide reflected the associated insulin resistance in these patients,Also It was concluded that C-peptide was a predictor of successful T2DM resolution .
LSG leads to significant improvement in biochemical glucose homeostasis and can be considered as a method of treatment in morbidly obese patients with glucose metabolism abnormalities. LSG as a method of treatment for patients with clinical type 2 diabetes.