Better 5-year outcomes for RYGB with silastic ring vs sleeve gastrectomy in type 2 diabetes
medwireNews: People with obesity are more likely to achieve sustained remission of type 2 diabetes if they undergo Roux-en-Y gastric bypass (RYGB) with a silastic band rather than sleeve gastrectomy, show the 5-year findings of a randomized trial.
Five years after surgery, 47% of the 53 people randomly assigned to undergo RYGB with a silastic band had remission of diabetes, defined as glycated hemoglobin levels below 42 mmol/mol (6%) without use of diabetes medications.
The corresponding rate for the 55 people assigned to undergo sleeve gastrectomy was 33%, giving a significant adjusted odds ratio of 6.78 favoring the RYGB group, Rinki Murphy (University of Auckland, New Zealand) reported at the virtual ADA 81st Scientific Sessions.
Bodyweight decreased by an average of 21.1% and 10.9% between surgery and 5 years in the RYGB and sleeve gastrectomy groups, respectively, with the difference between the two groups being statistically significant.
BMI reached its lowest point around 12 months after surgery, after which it increased gradually in both groups. “However, the gap between the bypass and the sleeve widened over time, with less weight regain after the bypass,” said Murphy.
Complication rates were similar in both groups across the 5 years, but the reduction in bone mineral density was significantly greater in the RYGB than sleeve gastrectomy group.
Murphy cautioned that use of a 6.5 cm silastic ring in this study, to prevent gastric pouch dilation, means the results may not apply to unbanded RYGB.
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