Three-Year Outcomes of Type 2 Diabetes Remission Following Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Patients With BMI ≥35: A Single-Center Cohort Study

TL;DR

This study compares the long-term effectiveness of two weight-loss surgeries in achieving diabetes remission in obese patients.

Contribution

The study provides three-year outcomes of diabetes remission after sleeve gastrectomy and gastric bypass in a Middle Eastern population.

Findings

RYGB showed higher T2DM remission rates (52.6%) compared to SG (39.3%) after three years.

RYGB patients were more likely to stop insulin use compared to SG patients.

Gender did not significantly affect diabetes remission outcomes.

Abstract

Background

Bariatric surgery is an effective treatment for obesity and type 2 diabetes mellitus (T2DM). Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) are the two most common procedures, but their outcomes in Middle Eastern populations are less well studied.

Objective

To describe and compare the three-year outcomes of T2DM remission after SG and RYGB in patients with BMI ≥35.

Methods

This was a retrospective cohort study of 162 patients with T2DM who underwent laparoscopic SG (n=84) or RYGB (n=78) at the Cleveland Clinic Abu Dhabi between 2017 and 2018. Patients were followed for at least three years. The main outcome was diabetes remission, defined as HbA1c <6.5% without glucose-lowering medication. We also examined changes in medication use and differences between males and females.

Results

The age range of patients was 39-74 years for the SG group and 41-72 years for the RYGB group, with no significant difference between them. At three years, 39.3% of patients who had SG and 52.6% of those who had RYGB achieved remission. Among patients on insulin at baseline, 30.0% (SG) and 37.9% (RYGB) went into remission. About half of the insulin users in each group were able to switch to oral medications only, and fewer remained on insulin after RYGB (13.8%) compared with SG (20.0%). In patients using only oral agents before surgery, remission was more frequent after RYGB (61.2%) than SG (44.4%). Remission rates were similar between men and women, indicating that gender did not significantly influence outcomes.

Conclusion

Both SG and RYGB were associated with remission of T2DM at three years in patients with BMI ≥35, with a higher proportion of remission observed after RYGB. Gender did not appear to affect outcomes.