Comparison of Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy in Obese Patients with Type 2 Diabetes

Background

Obesity and type 2 diabetes mellitus (T2DM) are illnesses with high prevalence, morbidity, and health-care costs. It has been shown that bariatric surgery is effective for inducing weight loss and maintaining adequate glucose control. Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG), which account for over 80% of surgical methods used globally, are the most frequently performed restrictive or malabsorptive surgical procedures in bariatric surgery.

Objective

To assess the efficacy of RYGB versus LSG in terms of weight loss and glycemic control for obese patients with T2DM.

Methods

In 220 patients with T2DM and prediabetes who underwent RYGB and LSG between 2016 and 2021, an observational and retrospective study was conducted. At 6, 12, 24, and 36 months post-surgery, diabetes and loss of weight were assessed.

Results

The study involved 220 patients, including 102 patients with prediabetes and 118 patients with diabetes. The longer surgery duration in the RYGB (68 vs. 50.2 minutes; p<0.001) was the only perioperative variable with a statistically significant difference. RYGB was associated with excess weight loss. Compared to those who received LSG, diabetic patients who underwent RYGB had a greater level of resolution or control. After 24 months of follow-up in patients with prediabetes, there was remission in both groups.

Conclusion

In patients with T2DM and prediabetes, RYGB and LSG had outstanding results in terms of losing weight and glycemic control, but in our patients, RYGB produced better outcomes in both categories.

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