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Roux-en-Y Gastric Bypass vs. Vertical Sleeve Gastrectomy for Diabetic Patients: 5 year outcomes

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

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