Energy balance
Bariatric surgery results in greater weight loss and higher rates of type 2 diabetes remission compared to sleeve gastrectomy, and is associated with reduced nephropathy and major adverse cardiovascular events.
For individuals with severe obesity and type 2 diabetes who have not achieved remission with lifestyle changes or medications, bariatric surgery (particularly Roux-en-Y gastric bypass) can be a highly effective option. It offers greater weight loss and diabetes remission rates than other surgical options like sleeve gastrectomy, along with reduced heart and kidney risks, though it carries higher surgical risks.
A recent 5-year retrospective study from Cleveland Clinic showed greater benefit from Roux-en-Y gastric bypass (RYGB) compared with sleeve gastrectomy (SG) for greater WL ... glycaemic control ... reduction of nephropathy ... and extended incident major adverse CV events (MACE)
Why this rating
Based on a retrospective observational study, which is lower evidence than RCTs.
Source
Examining the evidence for weight management in individuals with type 2 diabetes
W. Timothy Garvey et al. · Diabetes Obesity and Metabolism · 2022
DOI 10.1111/dom.14764
More from this paper
- Achieving a total body weight loss of 5% or higher in individuals with type 2 diabetes and obesity significantly improves glycemic control (reducing HbA1c) and reduces the utilization of glucose-lowering medications.Good
- Achieving a total body weight loss of 10% or more in individuals with type 2 diabetes leads to progressive improvements in glycemic control and cardiometabolic risk factors, and may be necessary to reduce mortality.Good
Related findings · Energy balance
- Achieving a total body weight loss of 10-15% (or >10-15 kg) through Total Diet Replacement (TDR) induces remission of Type 2 Diabetes in individuals with short-duration disease.Strong
- Bariatric surgery is superior to medical management alone for inducing significant long-term weight loss, remission of type 2 diabetes, and reduction in mortality for patients with BMI ≥ 40 or ≥ 35 with comorbidities.Strong
- Achieving type 2 diabetes remission requires significant weight loss (≥15 kg) via major caloric restriction, independent of macronutrient composition.Strong
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