Vanessa Boudreau, MD, Karen Barlow, Hons, BSc, Scott Gmora, MD, Dennis Hong, MD, Mehran Anvari, MD, PhD. Center for Minimal Access Surgery, McMaster University, Ontario, Canada
Introduction: Bariatric surgery is a known effective treatment for diabetes in obese patients.
Methods: Analysis of the Ontario Bariatric Registry data was performed to compare long term outcomes in diabetic patients who underwent Roux-en-Y Gastric Bypass (RYGB) or Vertical Sleeve Gastrectomy (VSG) between 2010-2018. Intention-to-treat analysis was performed. Results include conversions and revisions.
Results: Of the 5,101 diabetic patients that underwent bariatric surgery, 4,244 (83%) had RYGB (BMI 48.2, age 49.1; 75% female) and 847 (16.6%) had VSG (BMI 53.3, age 52.5; 69.1% female). There were 786 patients with RYGB available for follow up at 3 years and 198 patients at 5 years. Among the VSG patients, 92 were available for follow-up at 3 years and 17 at 5 years. There were 38 VSG patients that required a conversion due to weight regain/ineffective weight loss compared to 2 RYGB patients. Data below includes converted patients using intention to treat analysis.
|
|
RYGB |
VSG | p-value | |
|---|---|---|---|---|
| Conversion Rate |
3 years 5 years |
0.2% 1.0% |
32.6% 47.1% |
<0.05 <0.05 |
| Weight Loss | ||||
| %EWL |
3 years 5 years |
63.7% 60.3% |
43.6% 52.9% |
<0.05 NS |
| Diabetes Control | ||||
| No Diabetes Medication |
3 years 5 years |
69.8% 65.2% |
66.7% 56.2% |
NS NS |
| HbA1c |
3 years 5 years |
6.1% 6.3% |
6.3% 6.5% |
<0.05 NS |
| Remission (HbA1c <6%) |
3 years 5 years |
51.3% 47.3% |
45.5% 50% |
NS NS |
| Partial Remission (HbA1c <6.5%) |
3 years 5 years |
15.5% 16.3% |
15.6% 7.1% |
NS NS |
Conclusion : Both RYGB and VSG are effective with favorable weight loss and diabetes control. RYGB resulted in lower diabetes medication use and lower HbA1c at each follow-up.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94023
Program Number: P096
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster