Comparing Weight Loss Surgery Options

Gastric bypass was more effective for diabetes remission than gastric sleeve

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Choosing weight loss surgery is a major health decision, and it's important for patients to know their options. A recent study compared two weight loss surgeries for type 2 diabetes patients.

In this study, patients who were obese and had type 2 diabetes underwent either a gastric sleeve or gastric bypass weight loss surgery.

The researchers found that patients who had gastric bypass were more likely to achieve diabetes remission than those who had gastric sleeve surgery. Gastric bypass patients also lost more weight.

Remission means a large reduction or disappearance of symptoms.

These researchers suggested that gastric bypass may be more helpful than gastric sleeve surgery in helping obese patients with their type 2 diabetes.

"Talk to your doctor about weight loss surgery options."

Wei-Jei Lee, MD, PhD, of the Min-Sheng General Hospital in Taiwan, led this study.

People who are obese are at a greater risk of developing type 2 diabetes. In the long term, type 2 diabetes can lead to kidney, heart and blood vessel problems.

Management of type 2 diabetes often requires losing weight. Weight loss surgery can be a treatment option for people who cannot lose enough weight through a nutritious diet and more physical activity.

This study looked at how two different types of weight loss surgery affected people with type 2 diabetes.

These researchers compared laparoscopic sleeve gastrectomy, or a gastric sleeve, to gastric bypass.

Gastric sleeve procedures involve significantly reducing the size of the stomach by surgically removing part of it. The edges of the stomach are attached back together so that it is narrower, like a tube or banana.

In gastric bypass, a surgeon creates a small pouch in the upper part of the stomach. Part of the small intestine is then re-routed to connect to the new, smaller pouch.

Both of the surgeries are intended to make the patient to feel fuller with less food, causing the patient to lose weight.

This study involved 60 mildly obese diabetes patients with an average age of 45. Half of the patients underwent gastric sleeve surgery and the other half underwent gastric bypass.

The researchers followed up with the patients five years after the procedures. They took note of which patients had gone into remission of type 2 diabetes, meaning that the disease was no longer active.

A total of 72.7 percent of the gastric bypass patients were in remission five years later, while 42.8 percent of the gastric sleeve patients were in remission.

Patients who underwent gastric bypass also lost more weight, had lower BMIs and had lower blood sugar than those who underwent gastric sleeve.

The researchers noted that there were no differences in the effects of incretins, a group of hormones that affect insulin production after eating.

The authors of this study concluded that patients who had gastric bypass surgery were more likely to go into remission from type 2 diabetes than those who chose gastric sleeve surgery.

This research was presented at the Obesity Week conference on November 13. The researchers did not disclose funding sources or conflicts of interest.

Review Date: 
November 21, 2013
Last Updated:
November 22, 2013