Prospective Study Comparing Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on the Resolution of Obesity and Diabetes in a Native Hawaiian Population

Eden S Koo1, Racquel S Bueno, MD, FACS2, Cedric S Lorenzo, MD2. 1University of Michigan, 2University of Hawaii Department of Surgery

Introduction:  Obesity and diabetes disproportionately affect Native Hawaiians (NH).  Bariatric surgery, specifically the Roux-en-Y gastric bypass (RYGB), has been proven to be an effective treatment for both obesity and type 2 diabetes mellitus (T2DM) in this population.  In recent years, the sleeve gastrectomy (SG) has become more popular than the RYGB due in part to a belief in its equivalent effectiveness as a treatment for both obesity and T2DM. Because of the paucity of long-term  data supporting this, we sought to prospectively study and compare the effects of the LRYGB and SG on weight loss and diabetes resolution in a population of obese, diabetic Native Hawaiians.

Methods and Procedures: Twenty-five morbidly obese, diabetic Native Hawaiian patients were prospectively randomized into two groups. Fifteen underwent RYGB while 10 underwent SG. Clinical data was collected extending as far as 24 months post-operation.  Patient weight loss trends and other diagnostic data include fasting blood sugar (FBS) and hemoglobin A1C (HbA1c) were collected.  Data was analyzed for statistical significance.

Results: Both groups were equally matched in regards to gender, age, preoperative weight, BMI, FBS levels and HbA1C.  Mean %EBW loss, %FBS and %HbA1C decrease postoperatively are presented in the following graphs and tables. There was no statistically significant difference between the two groups.

Conclusion: Our data demonstrates minimal difference over time between SG and RYGB groups on most outcome measures, suggesting that the two groups are comparable in terms of postoperative weight loss and improvement in T2DM.  Both bariatric surgical procedures are therefore viable options in patients seeking to treat both their obesity and diabetes. 

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