Hormonal
Bariatric surgery procedures involving duodenal exclusion (Roux-en-Y gastric bypass and biliopancreatic diversion) achieve sustained Type 2 Diabetes remission rates exceeding 60% at 8 years, significantly outperforming adjustable gastric banding.
For patients with severe obesity and Type 2 Diabetes, Rou-en-Y Gastric Bypass (RYGB) or Biliopancreatic Diversion (BPD) offer the best chance for long-term diabetes remission (>60% at 8 years). Adjustable Gastric Banding is less effective for diabetes remission (45.6%) despite weight loss. Patients should prioritize procedures involving duodenal exclusion if T2D remission is a primary goal.
Remission of comorbidities was observed across all 3 groups, with key improvement (P < 0.01) in esophagitis in the RYGB group, and type 2 diabetes (T2D) (>60%) in procedures involving duodenal exclusion.
Why this rating
Prospective observational study with high follow-up (94%) and long duration (8 years), but lacks randomization.
Source
Surgical Prevention of Weight Regain and Type 2 Diabetes Recurrence in 3 Different Bariatric Operations and Their Differential Long-Term Outcome
Rudolf Steffen et al. · Annals of Surgery Open · 2021
DOI 10.1097/as9.0000000000000053
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