, Volume 56, Issue 9, pp 1914–1918 | Cite as

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

  • Andrei Keidar
  • Karen J. Hershkop
  • Limor Marko
  • Chaya Schweiger
  • Lior Hecht
  • Noam Bartov
  • Assaf Kedar
  • Ram WeissEmail author
Short Communication



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.


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.


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).


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 NCT00667706


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.


Bariatric surgery Roux-en-Y gastric bypass Sleeve gastrectomy Type 2 diabetes 



Roux-en-Y gastric bypass


Sleeve gastrectomy



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


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.

Supplementary material

125_2013_2965_MOESM1_ESM.pdf (77 kb)
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)
125_2013_2965_MOESM2_ESM.pdf (51 kb)
ESM Methods (PDF 50 kb)


  1. 1.
    Schauer PR, Kashyap SR, Wolski K et al (2012) Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 366:1567–1576PubMedCrossRefGoogle Scholar
  2. 2.
    Dixon JB, Zimmet P, Alberti KG, Rubino F (2011) International Diabetes Federation Taskforce on Epidemiology and Prevention. Bariatric surgery: an IDF statement for obese type 2 diabetes. Surg Obes Relat Dis 7:433–447PubMedCrossRefGoogle Scholar
  3. 3.
    Mingrone G, Castagneto-Gissey L (2009) Mechanisms of early improvement/resolution of type 2 diabetes after bariatric surgery. Diabetes Metab 35:518–523PubMedCrossRefGoogle Scholar
  4. 4.
    Rubino F, Forgione A, de Cummings et al (2006) The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg 244:741–749PubMedCrossRefGoogle Scholar
  5. 5.
    Schauer PR, Burguera B, Ikramuddin S et al (2003) Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg 238:467–484PubMedGoogle Scholar
  6. 6.
    Nannipieri M, Mari A, Anselmino M et al (2011) The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab 96:E1372–E1379PubMedCrossRefGoogle Scholar
  7. 7.
    Falkén Y, Hellström PM, Holst JJ, Näslund E (2011) Changes in glucose homeostasis after Roux-en-Y gastric bypass surgery for obesity at day three, two months, and one year after surgery: role of gut peptides. J Clin Endocrinol Metab 96:2227–2235PubMedCrossRefGoogle Scholar
  8. 8.
    Malandrucco I, Pasqualetti P, Giordani I et al (2012) Very-low-calorie diet: a quick therapeutic tool to improve β cell function in morbidly obese patients with type 2 diabetes. Am J Clin Nutr 95:609–613PubMedCrossRefGoogle Scholar
  9. 9.
    Lee WJ, Chong K, Ser KH et al (2011) Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg 146:143–148PubMedCrossRefGoogle Scholar
  10. 10.
    Jiménez A, Casamitjana R, Flores L et al (2012) Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg 256:1023–1029PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Andrei Keidar
    • 1
  • Karen J. Hershkop
    • 2
  • Limor Marko
    • 2
  • Chaya Schweiger
    • 1
  • Lior Hecht
    • 2
  • Noam Bartov
    • 2
  • Assaf Kedar
    • 1
  • Ram Weiss
    • 2
    Email author
  1. 1.Department of Surgery, Bariatric Surgery ClinicRabin Medical CenterPetach TikvaIsrael
  2. 2.Department of Human Metabolism and Nutrition, Braun School of Public HealthHebrew University School of MedicineJerusalemIsrael

Personalised recommendations