Insulin Cessation Rates and Glycemic Control Following Sleeve Gastrectomy and Roux-en-Y Gastric Bypa
Paul Sheils, Keyvan Heshmati, Carli Carbone, David Harris, Eric Sheu, Ali Tavakkoli
Brigham and Women's Hospital, Boston, MA, USA
Background: Diabetes remission following Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) have been well-studied. For insulin-treated type II diabetes (I-T2D), achieving insulin cessation is an important outcome, but less focus has been given to compare the two surgical procedures with this specific outcome in mind.
Methods: In a retrospective study of I-T2D patients who underwent LSG (n=76) or RYGB (n=103) between 2010 and 2015, data on weight outcomes (BMI), HbA1C and insulin use were recorded at regular intervals up to 1 year from surgery. Chi-square tests and t-tests were used for comparisons.
Results: Table 1 confirms similar baseline patient characteristics between LSG and RYGB groups. RYGB led to better weight loss than LSG, but rates of insulin cessation were similar between the groups (65% vs. 62%, respectively; p>0.05), with the majority of insulin cessation achieved within 2 weeks of surgery for both groups (Figure 1). RYGB, however, led to better HbA1C control than LSG.
Conclusion: RYGB and LSG lead to similar insulin cessation rates with the majority of the effect occurring early. By 6 months however, the additional weight loss with RYGB leads to better HbA1C levels.
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