TY - JOUR T1 - Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: A randomized controlled trial AU - Lee W, Chong K, Ser K, et al Y1 - 2011/02/01 N1 - 10.1001/archsurg.2010.326 JO - Archives of Surgery SP - 143 EP - 148 VL - 146 IS - 2 N2 - 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). SN - 0004-0010 M3 - doi: 10.1001/archsurg.2010.326 UR - http://dx.doi.org/10.1001/archsurg.2010.326 ER -