As recently summarized [
[1]
], there are only 4 randomized clinical trials (RCTs) in patients with type 2 diabetes
(T2D) comparing Roux-en-Y gastric bypass (RYGB) with sleeve gastrectomy (SG) and providing
level 1 evidence up to 5 years after randomization [
2
,
3
,
4
,
5
]. None of the individual studies were primarily designed and adequately powered to
compare the effects of RYGB with SG on T2D. However, combined analysis of these RCTs
(i.e., meta-analysis) to increase the sample size and statistical power (RYGB, n =
176 versus SG, n = 175) would indicate either there is no significant long-term difference
between RYGB and SG in improving T2D, or in case of a true difference (and we still
do not have enough statistical power to reveal the difference), that difference would
be <15% favoring RYGB [
[1]
].To read this article in full you will need to make a payment
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References
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- Individualized metabolic surgery score: procedure selection based on diabetes severity.Ann Surg. 2017; 266: 650-657
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Article info
Publication history
Published online: April 01, 2020
Identification
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© 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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- Selecting surgical procedures for medically uncontrolled type 2 diabetesSurgery for Obesity and Related DiseasesVol. 16Issue 7
- PreviewGuiding patients with type 2 diabetes (T2D) toward the most appropriate bariatric and metabolic procedure is crucial for improving outcomes. Aminian [1] published an interesting review based on high-quality scientific data. However, some important issues must be raised. Among the 4 randomized control trials (RCTs) that back up his review, 2 were not powered to detect differences related to T2D outcomes, as weight loss was their primary outcome and STAMPEDE was not powered to detect differences among Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), although indirectly shows that RYGB has better cardiovascular and glycemic outcomes than SG.
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