ADA 2021 | Higher 5-year outcomes for RYGB with silastic ring vs sleeve gastrectomy in sort 2 diabetes

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medwireNews: People with obesity are more likely to achieve sustained remission of type 2 diabetes if they undergo Roux-en-Y gastric bypass (RYGB) with a Silastic band instead of a gastric sleeve resection, show the 5-year results of a randomized Study.

Five years after surgery, 47% of the 53 people who were randomly assigned to a RYGB with a Silastic band had remission from diabetes, defined as glycated hemoglobin below 42 mmol / mol (6%) without taking any diabetes medication.

The corresponding rate for the 55 people who had gastric sleeve resection was 33%, giving a significant adjusted odds ratio of 6.78 in favor of the RYGB group, reported Rinki Murphy (University of Auckland, New Zealand) at the virtual ADA 81st Scientific Sessions.

The body weight decreased between the operation and the age of 5 in the RYGB and sleeve gastrectomy groups by an average of 21.1% and 10.9%, respectively, with the difference between the two groups being statistically significant.

The BMI bottomed out about 12 months after surgery, after which it gradually increased in both groups. “However, the gap between the bypass and the cuff has increased over time, with less weight gained after the bypass,” Murphy said.

The complication rates were similar in both groups over the 5 years, but the reduction in bone mineral density was significantly greater in the RYGB group than in the gastric sleeve gastrectomy group.

Murphy cautioned that using a 6.5 cm Silastic ring in this study to prevent gastric pouch dilation means the results may not apply to RYGB without a band.

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Scientific meetings of the ADA; 25-29 June 2021