RT Journal
A1 Lee W, Chong K, Ser K, et al
T1 Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: A randomized controlled trial
JF Archives of Surgery
JO Archives of Surgery
YR 2011
FD February 1
VO 146
IS 2
SP 143
OP 148
DO 10.1001/archsurg.2010.326
UL http://dx.doi.org/10.1001/archsurg.2010.326
AB Objectives 
    To determine the efficacies of 2 weight-reducing operations on diabetic control and the role of duodenum exclusion.Design 
    Double-blind randomized controlled trial.Setting 
    Department of Surgery of the Min-Sheng General Hospital, National Taiwan University.Patients 
    We studied 60 moderately obese patients (body mass index >25 and <35) aged >30 to <60 years who had poorly controlled type 2 diabetes mellitus (T2DM) (hemoglobin A1c [HbA1c] >7.5%) after conventional treatment (>6 months) from September 1, 2007, through June 30, 2008. Patients and observers were masked during the follow-up, which ended in 2009, 1 year after final enrollment.Interventions 
    Gastric bypass with duodenum exclusion (n = 30) vs sleeve gastrectomy without duodenum exclusion (n = 30).Main Outcome Measures 
    The primary outcome was remission of T2DM (fasting glucose <126 mg/dL and HbA1c <6.5% without glycemic therapy). Secondary measures included weight and metabolic syndrome. Analysis was by intention to treat.Results 
    Of the 60 patients enrolled, all completed the 12-month follow-up. Remission of T2DM was achieved by 28 (93%) in the gastric bypass group and 14 (47%) in the sleeve gastrectomy group (P = .02). Participants assigned to gastric bypass had lost more weight, achieved a lower waist circumference, and had lower glucose, HbA1c, and blood lipid levels than the sleeve gastrectomy group. No serious complications occurred in either group.Conclusions 
    Participants randomized to gastric bypass were more likely to achieve remission of T2DM. Duodenum exclusion plays a role in T2DM treatment and should be assessed.Trial Registration 
    clinicaltrials.gov Identifier: http://clinicaltrials.gov/show/NCT00540462>NCT00540462 (http://www.clinicaltrials.gov).