Type 2 diabetes mellitus status in obese patients following sleeve gastrectomy or one anastomosis gastric bypass

Abstract

This study aims to compare sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB) in terms of remission of type 2 diabetes mellitus (T2DM) in obese patients. All T2DM patients were followed-up for at least 36 months. The primary outcome was remission of T2DM. Secondary endpoints included weight reduction and the procedure’s impact on quality of life. In total, 53/1177 morbidly obese patients who underwent SG (Group A, n\u2009=\u200928) or OAGB (Group B, n\u2009=\u200925) had T2DM. Preoperatively, the mean Body Mass Index (BMI) values were 52.2\u2009±\u20098.5 kg/m2 and 52.9\u2009±\u200910.9 kg/m2 for Group A and Group B, respectively. Six patients in Group A were insulin dependent, while 8 were insulin dependent in Group B. After 36 months, diabetes remission was achieved by only 10 patients (35.7%) in Group A. However, in Group B, 22 patients (88%) remained off antidiabetic agents (p\u2009<\u20090.0001), with ΔHbA1c (%) reaching 1.4\u2009±\u20091.5% in Group A and 2.7\u2009±\u20092.1% in Group B (p\u2009=\u20090.02). Excess weight loss% (%EWL) was again significantly different between the two groups (MA\u2009=\u200979.8\u2009±\u200914.5%, MB\u2009=\u200993.3\u2009±\u200916.0%, p\u2009=\u20090.003). OAGB is more effective in improving glycaemic control and %EWL, with almost immediate resolution of diabetes, as well as long-term weight loss.