Early Improvement of Type 2 Diabetes Following Sleeve Gastrectomy and Roux-en-Y Gastric Bypass
Keyvan Heshmati, Carli Carbone, Paul Sheils, Eleanor Rudge, David Harris, Nicolas Levergood, Ashley Vernon, Malcolm Robinson, Scott Shikora, Ali Tavakkoli, Eric Sheu
Brigham and Women's Hospital, Boston, MA, USA
Background: While type 2 diabetes (T2D) improvement after sleeve gastrectomy (SG) is well documented, whether SG has a weight-independent impact on T2D is controversial. We compared T2D medication requirements in the early post-operative period after SG and Roux-en-Y gastric bypass (RYGB).
Methods: A prospective, single institution database was used to identify patients taking T2D medications who underwent SG (n=182) and RYGB (n=182) from 2010-2015. Demographics, T2D characteristics and medication use were gathered and analyzed by Chi-square or Student's t-tests.
Results: Prior to surgery, SG and RYGB patients were comparable, although RYGB patients had a slightly higher baseline HBA1c (Table 1). Reduction in T2D medication use occurred within days of surgery (Figure 1). More SG than RYGB patients were discharged off all T2D medications (38% vs 24%, P=0.003). However, by 3-months post-op, RYGB was superior to SG with greater T2D medication cessation (45% vs 62%, P=0.002), and lower BMI (RYGB: 35, SG: 38, p=0.003).
Conclusion: Both SG and RYGB markedly reduce T2D medication use within days of surgery, consistent with weight independent improvements in T2D. By 3-months post-op, RYGB is superior to SG for both T2D improvement and weight loss. 
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