Bariatric Procedure Selection in Patients with Type 2 Diabetes: Choice between Roux-en-Y Gastric Bypass or Sleeve Gastrectomy

Guiding patients with type 2 diabetes mellitus (T2DM) toward the most appropriate bariatric and metabolic procedure is crucial for improving outcomes. In recent years, Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been the most commonly performed bariatric procedures worldwide. Both are safe, effective, and durable metabolic procedures. The aim of this review is to critically examine the best available evidence derived from the randomized clinical trials (RCTs) to identify which bariatric procedure is superior in an individual with T2DM to provide sustainable long-term remission.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Review articles Source Type: research

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Objective: We sought to compare the short and long-term outcomes of MBS in adolescents vs. adults who have undergone a Roux-en-Y gastric bypass (RYGB) or Sleeve gastrectomy (SG).Design: Retrospective cohort study.Setting: Single tertiary care academic referral center.Participants: One hundred fifty adolescent (≤ 21-years) and adult (>21-years) subjects with severe obesity between 15 and 70 years of age who underwent RYGB or SG.Outcomes: Metabolic parameters, weight and height measures were obtained pre-and post-surgery (at 3 and 6 months, and then annually for 4 years).Results: Median pre-surgical body mass index (BM...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
ConclusionsMild-to-moderate PPHG is a frequent complication after bariatric surgery and results in smaller weight loss after 2  years. Age, baseline BMI, and an earlier glucose peak during OGTT predict PPHG after bariatric surgery.
Source: Obesity Surgery - Category: Surgery Source Type: research
CONCLUSION: This study reports similar T2DM resolution rates by both LRYGB and LSG during 1-5 years of follow-up. However, long-term follow-up of 10 years is needed to further substantiate these findings. PMID: 32148383 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Authors: Koch TR, Shope TR Abstract Obesity is a major factor in the worldwide rise in the prevalence of type 2 diabetes mellitus. The obesity "epidemic" will require novel, effective interventions to permit both the prevention and treatment of diabetes caused by obesity. Laparoscopic vertical sleeve gastrectomy is a newer bariatric surgical procedure with a lower risk of complications (compared to Roux-en-Y gastric bypass surgery). Based in part on restriction of daily caloric intake, sleeve gastrectomy has a major role in inducing significant weight loss and weight loss is maintained for at least 10&nbs...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
ConclusionsBoth LRYGB and LSG have comparative effect on resolving T2DM in nonseverely obese patients at midterm follow-up. Further RCTs should address the potential risks and long-term effects of LRYGB and LSG in nonseverely obese patients.
Source: Obesity Surgery - Category: Surgery Source Type: research
Conclusion: There are significant weight loss and improvement of glycaemic control at 12 months post-laparoscopic bariatric surgery among super-obese Malaysians.
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
Abstract Background: Bariatric surgery has been shown to induce type 2 diabetes mellitus (T2DM) remission in severely obese patients. After laparoscopic Roux-en-Y gastric bypass (LRYGB), diabetes remission occurs early and independently of weight loss. Previous research has identified preoperative factors for remission, such as duration of diabetes and HbA1c. Understanding factors that predict diabetes remission can help to select patients who will benefit most from bariatric surgery. Methods: We retrospectively reviewed all T2DM patients who underwent laparoscopic sleeve gastrectomy (LSG) or LRYGB between Ja...
Source: Canadian Journal of Surgery - Category: Surgery Authors: Tags: Can J Surg Source Type: research
AbstractBariatric surgery (BS), including sleeve gastrectomy (SG), gastric bypass (GB), and ileal transposition (IT), is one of the approaches currently used for the correction of metabolic disturbances in type 2 diabetes mellitus (DM2) with obesity. However, the efficiency of these approaches and their impact on hypothalamic signaling and hormonal status in severe forms of DM2 without obesity remain poorly characterized. The aim of this work is to study the effect of IT, SG, and GB on insulin, leptin, ghrelin, and glucagon-like peptide-1 (GLP-1) levels in the blood and on the expression of the genes encoding the main comp...
Source: Advances in Gerontology - Category: Geriatrics Source Type: research
Conclusions: Bariatric surgery appears to be capable of partially reversing the obesity-related epigenome. The identification of potential epigenetic biomarkers predictive for the success of bariatric surgery may open new doors to personalized therapy for severe obesity. Introduction Obesity is currently a huge healthcare problem, worldwide, and is a risk factor for several diseases such as type 2 diabetes (T2D), cardiovascular disease and cancer (1). As the prevalence of obesity reaches pandemic proportions, this metabolic disease is estimated to become the biggest cause of mortality in the near future (2). In fact,...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Authors: Wang FG, Bai RX, Yan WM, Yan M, Dong LY, Song MM Abstract The modulation of the gut microbiota was recently deemed one of the mechanisms responsible for the excellent outcomes of bariatric surgery. However, to date, only few studies have assessed this, and they have high heterogeneity. In the present study, next-generation 16S ribosomal DNA amplicon sequencing was used to characterize the gut microbiota of healthy volunteers, as well as patients prior to and after sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Significant differences in α diversity, β diversity and species were iden...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
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