Key result
Sleeve gastrectomy is associated with ~63% one-year diabetes resolution, surpassing gastric banding but matching bypass.
Why the study?
The efficacy of different bariatric surgical procedures to induce diabetes remission and reduce cardiovascular risk factors in obese patients with type 2 diabetes was unclear.
Do different bariatric surgery procedures differ in their efficacy to induce diabetes remission and lower cardiovascular risk factors in obese patients with type 2 diabetes?
Cohort (n=81)
No
Do different bariatric surgery procedures differ in their efficacy to induce diabetes remission and lower cardiovascular risk factors in obese patients with type 2 diabetes?
Absolute Event Rate: 62.5% vs 20%
p-value: p=< 0.01
Sleeve gastrectomy and gastric bypass appear more effective than gastric banding for inducing diabetes remission and lowering LDL-cholesterol at 1 year in obese patients with type 2 diabetes.
May favor sleeve or bypass over banding for diabetes remission in obese T2D; leaves open randomized confirmation of CV benefits.
AIM: The aim of the present retrospective study was to evaluate the efficacy of four bariatric surgical procedures to induce diabetes remission and lower cardiovascular risk factors in diabetic obese patients. Moreover, the influence of surgery on weight evolution in the diabetic population was compared with that observed in a nondiabetic matched population. METHODS: Among 970 patients who were operated on in our center since 2001, 81 patients were identified as type 2 diabetes. Laparoscopic adjustable gastric banding (GB), intervention type Mason (MA), gastric bypass (RYGB), and sleeve gastrectomy (SG) were performed, respectively, in 25%, 17%, 28%, and 30% of this diabetic population. RESULTS: The resolution rate of diabetes one year after surgery was significantly higher after SG than GB (62.5% versus 20%, P < 0.01), but not significantly different between SG and RYGB. In terms of LDL-cholesterol reduction, RYGB was equivalent to SG and superior to CGMA or GB. Considering the other cardiovascular risk factors, there was no significant difference according to surgical procedures. The weight loss was not statistically different between diabetic and nondiabetic matched patients regardless of the surgical procedures used. CONCLUSION: Our data confirm that the efficacy of surgery to treat diabetes is variable among the diverse procedures and SG might be an interesting option in this context.
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Pham et al. (2014) conducted a cohort in Type 2 diabetes and obesity (n=81). Sleeve gastrectomy (SG) vs. Gastric banding (GB), gastric bypass (RYGB), and Mason intervention (MA) was evaluated on Resolution rate of diabetes (p=< 0.01). Sleeve gastrectomy resulted in a significantly higher diabetes resolution rate at one year compared to gastric banding (62.5% vs 20%, P<0.01), but was not significantly different from gastric bypass.
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