The effect of different types of laparoscopic bariatric procedures on type 2 diabetic obese patients

Abstract

Background: The rising global incidence and prevalence of type II diabetes (T2DM) has paralleled the rise in obesity. Bariatric surgery is currently the most effective treatment for obesity compared to maximal medical and lifestyle management. Objectives: This work aimed to compare the efficacy and safety of LSG (group 1), (LRYGB) (group 2) and (MGB) (group 3) for T2DM obese patients. Patients and Methods: A randomized prospective clinical study for 225 patients with morbid obesity (BMI 35 kg/m2 or more with T2DM) treated by laparoscopic sleeve gastrectomy (LSG),laparoscopic Roux-en-Y gastric bypass(LRYGB) and mini gastric bypass (MGB),(75 patients in each group) conducted in Qena and Alexandria university hospitals from March 2019 to September 2020.The primary outcome was complete remission of type 2 diabetes with hyperglycemia control, (HbA1c <6 %). The secondary outcome was weight loss is by calculating the percentage of excess weight loss (% EWL) Results: There was statistically significant difference between the three studied groups regarding time of surgery (96.5 ± 17.6, 107.3 ± 19.4, and 106.6 ± 15.8 among group 1, 2, and 3respectively; P-value < 0.05). There was no statistically significant difference between the three studied groups regarding hospital staying duration and postoperative complication. There was no statistically significant difference between the three studied groups regarding HbA1C post-operative. Conclusion: Metabolic surgery has emerged as the single most effective treatment option for T2DM and obesity. There is a potential superiority of the LRYGB and MGB over the LSG in obtaining diabetes remission.

Keywords

• bariatric surgery; diabetes; gastric bypass; sleeve gastrectomy