The aim of this study was to evaluate the short-term efficacy of single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) using a 400-cm common limb in Chinese patients with obesity of low BMI (<35 kg/m²) and type 2 diabetes (T2D). Sixteen patients who underwent SADI-S between June 2022 and November 2023 were retrospectively analyzed and evaluated at 6 and 12 months postoperatively. The primary outcome was the rate of diabetes remission (HbA1c < 6.5% without antidiabetic medications for ≥ 3 months). Secondary outcomes included excess and total weight loss (EWL and TWL) and nutritional deficiencies. At 12 months postoperatively, 80% of patients achieved diabetic remission, with mean HbA1c decreasing from 8.84 ± 1.55 to 5.93 ± 0.74%. Mean BMI decreased from 30.64 ± 2.29 to 22.91 ± 2.33 kg/m², and EWL and TWL reached 122.12% ± 44.43% and 25.01% ± 8.02%, respectively. Nutritional status remained stable with no cases of hypoalbuminemia and fewer iron and vitamin deficiencies. SADI-S with a 400-cm common limb was effective in achieving glycemic control and weight loss while reducing the risk of nutritional deficiencies in Chinese patients with obesity of low BMI and T2D.
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