Diabetes improvement and resolution following laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures: a systematic review of randomized controlled trials

Osland, Emma; Alam, Khorshed; Khan, Shahjahan; Memon, Breda; Memon, Muhammed Ashraf

doi:10.1007/s00464-016-5202-5

Cited by 47 publications

(37 citation statements)

References 46 publications

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“…Numerous clinical studies have concluded that VSG is not or is only marginally less effective in producing weight loss, at least in the short term [7–15] and this was an important factor to spur the present preference for VSG as the bariatric surgery of choice. Only a few clinical studies have found VSG to be significantly less efficient in producing sustained body weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…Translating relative lifespans between mice and humans, 12 mouse weeks equates to approximately 7 human years, but most available data from VSG in humans covers only 1–3 years [7–15]. Thus, more long-term data with observation periods of up to 20 years are needed to make informed conclusions about the efficiency of VSG in patients with obesity.…”

Section: Discussionmentioning

confidence: 99%

“…However, a common problem with such studies, particularly VSG, is that they are relatively short-term, rarely looking beyond 3 years after surgery [7–15]. …”

Section: Introductionmentioning

confidence: 99%

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RYGB Produces more Sustained Body Weight Loss and Improvement of Glycemic Control Compared with VSG in the Diet-Induced Obese Mouse Model

et al. 2017

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Objective To compare the effects of murine models of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) surgery on body weight, body composition, food intake, energy expenditure, and glycemic control. Background Weight regain and type-2 diabetes relapse has been reported in a significant proportion of VSG patients in some studies, but definitive conclusions regarding the long-term comparative effectiveness of VSG and RYGB are lacking both in humans and rodent models. Methods VSG, RYGB, and sham surgery was performed in high-fat diet-induced obese mice and the effects on body weight and glycemic control were observed for a period of 12 weeks. Results After the initial weight loss, VSG mice regained significant amounts of body weight and fat mass that were only marginally lower than in sham-operated mice. In contrast, RYGB produced sustained loss of body weight and fat mass up to 12 weeks, and drastically improved fasting insulin and HOMA-IR compared with sham-operated mice. Using weight-matched control groups we also found that the adaptive hypometabolic response to weight loss was blunted by both VSG and RYGB, and that despite large weight/fat regain, fasting insulin and HOMA-IR were markedly improved, but not reversed, in VSG mice. Conclusions VSG is less effective to lastingly suppress body weight and improve glycemic control compared with RYGB in mice. Given similar observations in many human studies, the run towards replacing RYGB with VSG is premature and should await carefully controlled randomized long term trials with VSG and RYGB.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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RYGB Produces more Sustained Body Weight Loss and Improvement of Glycemic Control Compared with VSG in the Diet-Induced Obese Mouse Model

et al. 2017

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“…Totally, it could be concluded that diabetes resolution refers to changes in biochemical parameters and reduction or cessation of medication requirements and it coul be derived by the assessment by endocrinologist/physician, responsible for follow-up visits. The most frequently utilized methods for defining T2DM remission are changes to oral hypoglycemic agents or insulin requirements and biochemical measures (32). Due to different definitions of diabetes remission after bariatric surgery in several studies the exact rate of complete and partial remission after LRYGB and OAGB, an accurate comparison requires meta-analysis studies.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Roux-en-Y versus One Anastomosis Gastric Bypass on Remission of Diabetes in Morbid Obesity

Abed

Kabir

Jamshidi

et al. 2017

J Minim Invasive Surg Sci

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Background: Laparoscopic one anastomosis gastric bypass (OAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are common treatments for morbid obese patients who suffer from type 2 diabetes mellitus (T2DM). It has been hypothesized that diabetes may be resolved or improved after bariatric procedures, although the exact effect has not been well established. The present study aimed to compare remission of T2DM after LRYGB versus OAGB in this study. Methods: All diabetic obese patients, aged between 16 to 60, who referred to Hazrat Rasul Akram obesity clinic from April 2010 to March 2013 for LRYGB or OAGB were included in the present study. Pre-operative parameters, including glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), and type of diabetes medication were extracted from database and recorded. Pre-operative and three months postoperative values were then compared between the groups. Results: Out of 95 eligible patients, 50 patients underwent OAGB and 45 patients had LRYGB. The two groups were homogenous in distribution of gender, mean age, weight, BMI, and FPG; however, mean HbA1C was relatively higher in LRYGB group (P = 0.05) than other group, which was non-significant after adjustment. Rate of remission was significantly higher in OAGB group than other group after three months follow-up (64.0 versus 31.1%, respectively) (P = 0.002). Conclusions: In our short-term follow-up, OAGB had a higher rate of remission of T2DM compared to LRYGB, which could be due to different baseline value of HbA1c (before surgery) between two groups. Future research is thus suggested with linger follow-up and randomized study design.

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“…The meta‐analysis was also flawed by duplicate publications, and it did not exclude studies of variants of gastric bypass, such as banded and mini gastric bypass. Another systematic review of RCTs from 2017 suggested that RYGB and SG were equally effective in resolving T2DM in patients with obesity but that further studies were required. Reviews including both RCTs and retrospective studies have concluded that RYGB is associated with better resolution and control of T2DM than SG, while one review found no difference between the procedures .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the effect of Roux‐en‐Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials

et al. 2020

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Bariatric surgery is an effective treatment option for patients with type 2 diabetes mellitus (T2DM) and obesity. This study aims to compare the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on remission of T2DM. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials weresearched for studies published between database inception and 21 November 2019.A meta-analysis, using a random effects model, was performed to calculate relative risk (RR) of T2DM remission between the groups in randomized controlled trials (RCTs). Of 2650 records identified, 12 records from 10 different RCTs were finally included. The studies comprised 705 patients with follow-up from 1 to 5 years. The remission rate of T2DM at 1 year was higher among those undergoing RYGB (156/276, 57%) compared with those undergoing SG (128/275, 47%), RR (95% CI) 1.20 (1.00-1.45), P = .047, I 2 = 24.9%, moderate-quality evidence. Among studies with 2-to 5-year follow-up, there was no difference in remission rates between the RYGB (132/263, 50%) and SG (121/266, 46%) groups, RR 1.06 (0.94-1.20), P = .34, I 2 = 0.0%, low-quality evidence. RYGB resulted in a higher rate of T2DM remission compared with SG after 1 year. The T2DM remission rates did not differ in studies with 2-to 5-year follow-up. K E Y W O R D SRoux-en-Y gastric bypass, sleeve gastrectomy, systematic review, type 2 diabetes mellitus Abbreviations: BMI, body mass index; CI, confidence interval; RCT, randomized controlled trial; RR, relative risk; RYGB, Roux-en-Y gastric bypass; SD, standard deviation; SG, sleeve gastrectomy; T2DM, type 2 diabetes mellitus.

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Diabetes improvement and resolution following laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures: a systematic review of randomized controlled trials

Cited by 47 publications

References 46 publications

RYGB Produces more Sustained Body Weight Loss and Improvement of Glycemic Control Compared with VSG in the Diet-Induced Obese Mouse Model

RYGB Produces more Sustained Body Weight Loss and Improvement of Glycemic Control Compared with VSG in the Diet-Induced Obese Mouse Model

Laparoscopic Roux-en-Y versus One Anastomosis Gastric Bypass on Remission of Diabetes in Morbid Obesity

Comparison of the effect of Roux‐en‐Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials

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