Abstract

This study aimed to compare the long-term weight loss results, remission of comorbidities and nutritional deficiencies of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and One-Anastomosis gastric bypass (OAGB) on type 2 diabetic (T2D) patients. Patients and Methods: A retrospective analysis of all the morbidly obese and diabetic patients undergoing SG, RYGB, and OAGB as primary bariatric procedures between February 2010 and June 2015 was performed. Anthropometric parameters, remission of comorbidities, nutritional deficiencies and supplementation requirements at 1, 2 and 5 years’ follow-up were monitored. Patients lost to follow-up 5 years after surgery were excluded from the analysis. Results: 358 patients were included. The follow-up rate was 84.8%. Finally, 83 SG, 152 RYGB, and 123 OAGB patients were included in the analysis. OAGB obtained significantly greater weight loss and remission of dyslipidemia than the other techniques. There was a trend towards greater T2D and hypertension remission rate after OAGB, while fasting glucose and glycated hemoglobin levels were significantly lower after OAGB. There were no significant differences in hemoglobin or protein levels between groups. SG obtained lower iron deficiencies than the other techniques, while there were no significant differences in other nutritional deficiencies between groups. Conclusion: OAGB obtained greater weight loss and remission of dyslipidemia than RYGB or SG. Excluding lower iron deficiency rates after SG, there were no significant differences in the development of nutritional deficiencies between groups.

Highlights

  • Obesity and its comorbidities are a global health problem, mainly in developed countries

  • It is remarkable that the prevalence of dyslipidemia and hypertension is greater among this type 2 diabetes mellitus (T2D) population than that reported in other studies, including T2D and non-T2D patients

  • This study describes the results of weight loss, remission of comorbidities and nutritional deficiencies of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and One-Anastomosis gastric bypass (OAGB) in patients with type 2 diabetes (DM2)

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Summary

Introduction

Obesity and its comorbidities are a global health problem, mainly in developed countries. Morbid obesity has shown an exponential growth [1]. Bariatric surgery has demonstrated to be the most effective method in achieving sustained weight loss and reducing obesity-related comorbidities, especially type 2 diabetes mellitus (T2D) and cardiovascular risk [2,3,4]. The number of bariatric procedures is continuously increasing, and surgical concepts are evolving in pursuit of an “ideal. Res. Public Health 2020, 17, 7644; doi:10.3390/ijerph17207644 www.mdpi.com/journal/ijerph

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