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Roux-en-Y gastric bypass vs sleeve gastrectomy for obese patients with type 2 diabetes: a randomised trial

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Abstract

Aims/hypothesis

Bariatric surgery is gaining acceptance as a ‘metabolic surgical intervention’ for patients with type 2 diabetes. The optimal form of surgery and the mechanism of action of these procedures are much debated. We compared two bariatric procedures for obese patients with type 2 diabetes and evaluated their effects on HbA1c and glucose tolerance.

Methods

We performed a parallel un-blinded randomised trial of Roux-en-Y gastric bypass (RYGB) vs sleeve gastrectomy (SG) in 41 obese patients with type 2 diabetes, who were bariatric surgery candidates attending the obesity clinic. HbA1c, body composition and glucose tolerance were evaluated at baseline, and at 3 and 12 months.

Results

Of the 41 patients, 37 completed the follow-up (19 RYGB, 18 SG). Both groups had similar baseline anthropometric and biochemical measures, and showed comparable weight loss and fat:fat-free mass ratio changes at 12 months. A similar normalisation of HbA1c levels was observed as early as 3 months post-surgery (6.37 ± 0.71% vs 6.23 ± 0.69% for RYGB vs SG respectively, p < 0.001 in both groups for baseline vs follow-up).

Conclusions/interpretation

In this study, RYGB did not have a superior effect in comparison to SG with regard to HbA1c levels or weight loss during 12 months of follow-up.

Trial registration

ClinicalTrials.gov NCT00667706

Funding

This work was supported by grant no. 3-000-8480 from the Israel Ministry of Health Chief Scientist, the Stephen Morse Diabetes Research Foundation and by Johnson & Johnson.

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Fig. 1

Abbreviations

RYGB:

Roux-en-Y gastric bypass

SG:

Sleeve gastrectomy

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Acknowledgements

We wish to thank our patients for their time and efforts while participating in this study.

Funding

This study was partly funded by research grants from the Israel Ministry of Health Chief Scientist (to RW), the Stephen Morse Diabetes Research Foundation (to RW) and Johnson & Johnson (to AK).

Duality of interest

The authors declare that there is no duality of interest associated with this manuscript.

Contribution statement

AK and KJH acquired the data, analysed it and wrote the manuscript. LM, CS, LH, NB and AsK took part in the clinical care and the interpretation of the analysis, and also reviewed the manuscript. RW designed the study, acquired and analysed the data, and wrote the manuscript. All authors reviewed and approved the final version of the manuscript.

Author information

Authors and Affiliations

  1. Department of Surgery, Bariatric Surgery Clinic, Rabin Medical Center, Petach Tikva, Israel

    Andrei Keidar, Chaya Schweiger & Assaf Kedar

  2. Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University School of Medicine, PO Box 12272, Jerusalem, Israel, 91120

    Karen J. Hershkop, Limor Marko, Lior Hecht, Noam Bartov & Ram Weiss

Authors
  1. Andrei Keidar
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  2. Karen J. Hershkop
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  3. Limor Marko
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  4. Chaya Schweiger
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  5. Lior Hecht
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  6. Noam Bartov
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  7. Assaf Kedar
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  8. Ram Weiss
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Corresponding author

Correspondence to Ram Weiss.

Additional information

Andrei Keidar and Karen J. Hershkop contributed equally to this work

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM Fig. 1

Flow chart of the study. Forty one participants with T2DM were recruited (22 randomized to RYGB and 19 randomized to SG). Nineteen patients in the RYGB and 18 in the SG arms completed the study (PDF 76 kb)

ESM Methods

(PDF 50 kb)

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Keidar, A., Hershkop, K.J., Marko, L. et al. Roux-en-Y gastric bypass vs sleeve gastrectomy for obese patients with type 2 diabetes: a randomised trial. Diabetologia 56, 1914–1918 (2013). https://doi.org/10.1007/s00125-013-2965-2

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  • DOI: https://doi.org/10.1007/s00125-013-2965-2

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