Matías Sepúlveda1,2, Munir Alamo3, Yudith Preiss4, Juan P Valderas5. 1. Bariatric and Metabolic Surgery Center, Dipreca Hospital, Vital Apoquindo 1200, Las Condes, Santiago, Chile. drmsepulveda@gmail.com. 2. Escuela de Medicina, Universidad Diego Portales, Santiago, Chile. drmsepulveda@gmail.com. 3. Hospital El Carmen, Camino A Rinconada 1201, Maipú, Santiago, Chile. 4. Bariatric and Metabolic Surgery Center, Dipreca Hospital, Vital Apoquindo 1200, Las Condes, Santiago, Chile. 5. Facultad de Medicina - Odontología, Universidad de Antofagasta, Badajoz 100, Las Condes, Santiago, Chile.
Abstract
INTRODUCTION: Sleeve gastrectomy with jejunal bypass (SGJB) and Roux-en-Y gastric bypass (RYGB) has shown good results with respect to type 2 diabetes mellitus (T2D) remission in our institution. In this study, we compared the efficacy and safety of SGJB versus RYGB in terms of T2D remission up to 3 years postoperatively. MATERIALS AND METHODS: A retrospective cohort study of two groups of patients with T2D who underwent SGJB or RYGB. All patients were matched by age, presurgical body mass index (BMI), glycated hemoglobin (HbA1c), and diabetes duration. Complete remission was defined as HbA1c of < 6%, fasting plasma glucose (FPG) of < 100 mg/dL, and no antidiabetic drugs. RESULTS: In total, 57 and 55 patients in the SGJB and RYGB groups, respectively, met the inclusion criteria. The diabetes remission rate was similar between the SGJB and RYGB groups at 1 year postoperatively (69.2 vs. 64.7%) and 3 years postoperatively (56.1 vs. 58.8%). There were no significant differences in HbA1c or FPG at 1 or 3 years between the two groups. Additionally, weight loss and other metabolic parameters were similar between the groups. Clinical chemistry values were similar at 12 months except for hematocrit and calcium, which were significantly lower in the RYGB group. There were no differences in surgical complications. CONCLUSIONS: Both procedures showed similar results in terms of T2D remission and other metabolic markers at 3 years. Hematocrit and calcium were significantly higher in the SGJB than RYGB group. SGJB is as effective and safe as RYGB in obese patients with T2D.
INTRODUCTION: Sleeve gastrectomy with jejunal bypass (SGJB) and Roux-en-Y gastric bypass (RYGB) has shown good results with respect to type 2 diabetes mellitus (T2D) remission in our institution. In this study, we compared the efficacy and safety of SGJB versus RYGB in terms of T2D remission up to 3 years postoperatively. MATERIALS AND METHODS: A retrospective cohort study of two groups of patients with T2D who underwent SGJB or RYGB. All patients were matched by age, presurgical body mass index (BMI), glycated hemoglobin (HbA1c), and diabetes duration. Complete remission was defined as HbA1c of < 6%, fasting plasma glucose (FPG) of < 100 mg/dL, and no antidiabetic drugs. RESULTS: In total, 57 and 55 patients in the SGJB and RYGB groups, respectively, met the inclusion criteria. The diabetes remission rate was similar between the SGJB and RYGB groups at 1 year postoperatively (69.2 vs. 64.7%) and 3 years postoperatively (56.1 vs. 58.8%). There were no significant differences in HbA1c or FPG at 1 or 3 years between the two groups. Additionally, weight loss and other metabolic parameters were similar between the groups. Clinical chemistry values were similar at 12 months except for hematocrit and calcium, which were significantly lower in the RYGB group. There were no differences in surgical complications. CONCLUSIONS: Both procedures showed similar results in terms of T2D remission and other metabolic markers at 3 years. Hematocrit and calcium were significantly higher in the SGJB than RYGB group. SGJB is as effective and safe as RYGB in obesepatients with T2D.
Authors: Bent J Nergård; Andreas Lindqvist; Hjörtur G Gislason; Leif Groop; Mikael Ekelund; Nils Wierup; Jan L Hedenbro Journal: Surg Obes Relat Dis Date: 2015-04-02 Impact factor: 4.734
Authors: Annette von Drygalski; Deborah A Andris; Peter R Nuttleman; Scott Jackson; John Klein; James R Wallace Journal: Surg Obes Relat Dis Date: 2010-05-08 Impact factor: 4.734
Authors: John B Buse; Sonia Caprio; William T Cefalu; Antonio Ceriello; Stefano Del Prato; Silvio E Inzucchi; Sue McLaughlin; Gordon L Phillips; R Paul Robertson; Francesco Rubino; Richard Kahn; M Sue Kirkman Journal: Diabetes Care Date: 2009-11 Impact factor: 19.112
Authors: Michelle R Lent; Peter N Benotti; Tooraj Mirshahi; Glenn S Gerhard; William E Strodel; Anthony T Petrick; Jon D Gabrielsen; David D Rolston; Christopher D Still; Annemarie G Hirsch; Fahad Zubair; Adam Cook; David J Carey; G Craig Wood Journal: Diabetes Care Date: 2017-07-31 Impact factor: 19.112