Mini-Gastric Bypass Significantly Better than Sleeve

Mini-Gastric Bypass Roughly Twice as good as the Sleeve gastrectomy for type 2 diabetes mellitus:

Double-blind randomized controlled trial.

Remission of T2DM was achieved by 28 (93%) in the gastric bypass group and 14 (47%) in the sleeve gastrectomy group (P = .02).

Participants randomized to mini-gastric bypass were more likely to achieve remission of diabetes.

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Amplify’d from www.ncbi.nlm.nih.gov
Arch Surg. 2011 Feb;146(2):143-8.

Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial.

Source

Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taiwan, Republic of China.

Abstract

OBJECTIVES:

To determine the efficacies of 2 weight-reducing operations on diabetic control and the role of duodenum exclusion.

DESIGN:

Double-blind randomized controlled trial.

SETTING:

Department of Surgery of the Min-Sheng General Hospital, National Taiwan University.

PATIENTS:

We studied 60 moderately obese patients (body mass index >25 and <35) aged >30 to <60 years who had poorly controlled type 2 diabetes mellitus (T2DM) (hemoglobin A(1c) [HbA(1c)] >7.5%) after conventional treatment (>6 months) from September 1, 2007, through June 30, 2008. Patients and observers were masked during the follow-up, which ended in 2009, 1 year after final enrollment.

INTERVENTIONS:

Gastric bypass with duodenum exclusion (n = 30) vs sleeve gastrectomy without duodenum exclusion (n = 30).

MAIN OUTCOME MEASURES:

The primary outcome was remission of T2DM (fasting glucose <126 mg/dL and HbA(1c) <6.5% without glycemic therapy). Secondary measures included weight and metabolic syndrome. Analysis was by intention to treat.

RESULTS:

Of the 60 patients enrolled, all completed the 12-month follow-up. Remission of T2DM was achieved by 28 (93%) in the gastric bypass group and 14 (47%) in the sleeve gastrectomy group (P = .02). Participants assigned to gastric bypass had lost more weight, achieved a lower waist circumference, and had lower glucose, HbA(1c), and blood lipid levels than the sleeve gastrectomy group. No serious complications occurred in either group.

CONCLUSIONS:

Participants randomized to gastric bypass were more likely to achieve remission of T2DM. Duodenum exclusion plays a role in T2DM treatment and should be assessed. Trial Registration clinicaltrials.gov Identifier: NCT00540462 (http://www.clinicaltrials.gov).

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