Roux-en-Y Gastric Bypass or Sleeve Gastrectomy for Type 2 Diabetes: Expanding Role of Individualized Metabolic Surgery (IMS) Score

As recently summarized1, there are only four randomized clinical trials (RCTs) in patients with type 2 diabetes mellitus (T2DM) comparing Roux-en-Y gastric bypass (RYGB) with sleeve gastrectomy (SG) and providing level I evidence up to 5 years after randomization.2-5 None of the individual studies were primarily designed and adequately powered to compare the effects of RYGB with SG on T2DM. However, combined analysis of these RCTs (i.e. meta-analysis) in order to increase the sample size and statistical power (RYGB, n=176 versus SG, n=175) would indicate that either there is no significant long-term difference between RYGB and SG in improving T2DM, or in case of a true difference (and we still don ’t have enough statistical power to reveal the difference), that difference would be less than 15% favoring RYGB.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Letter to the Editor Source Type: research