Abstract
Bariatric surgery is a treatment option for obese patients with type 2 diabetes mellitus (T2DM). Although sleeve gastrectomy (SG) is growing in favor, some randomized trials show less weight loss and HbA1c improvement compared with Roux-en-Y gastric bypass (RYGB). The study objective was to compare changes in beta-cell function with similar weight loss after SG and RYGB in obese patients with T2DM. Subjects undergoing SG or RYGB were studied with an intravenous glucose tolerance test before surgery and at 5–12% weight loss post-surgery. The primary endpoint was change in the disposition index (DI). Baseline BMI, HbA1c, and diabetes-duration were similar between groups. Mean total weight loss percent was similar (8.4% ± 0.4, p = 0.22) after a period of 21.0 ± 1.7 days. Changes in fasting glucose, acute insulin secretion (AIR), and insulin sensitivity (Si) were similar between groups. Both groups showed increases from baseline to post-surgery in DI (20.2 to 163.3, p = 0.03 for SG; 31.2 to 232.9, p = 0.02 for RYGB) with no significant difference in the change in DI between groups (p = 0.53). Short-term improvements in beta-cell function using an IVGTT were similar between SG and RYGB. It remains unclear if longer-term outcomes are better after RYGB due to greater weight loss and/or other factors.
Highlights
The objective of the present study was to delineate changes in beta-cell function after sleeve gastrectomy (SG) in patients with type 2 diabetes mellitus (T2DM), and to compare these changes to a Roux-en-Y gastric bypass (RYGB) cohort after similar weight loss
Data were analyzed by two-way repeated measures ANOVA and no group x time interaction was detected for glucose (p = 0.82), Si (p = 0.47), acute insulin secretion (AIR) (p = 0.43) or disposition index (DI) (p = 0.53) values, time was significant for all these parameters
This study demonstrates that SG results in a similar short-term improvement in beta-cell function compared with RYGB in subjects with T2DM
Summary
The objective of the present study was to delineate changes in beta-cell function after SG in patients with T2DM, and to compare these changes to a RYGB cohort after similar weight loss
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