PMID- 38182725
OWN - NLM
STAT- MEDLINE
DCOM- 20240108
LR  - 20240108
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 14
IP  - 1
DP  - 2024 Jan 5
TI  - Comparative evaluation of early diabetic outcomes in southeast asian patients 
      with type 2 diabetes mellitus undergoing Roux-en-Y gastric bypass (RYGB) versus 
      sleeve gastrectomy (LSG).
PG  - 614
LID - 10.1038/s41598-024-51384-1 [doi]
LID - 614
AB  - Obesity and type 2 diabetes mellitus (T2DM) is an alarming problem globally and a 
      growing epidemic. Metabolic surgery has been shown to be successful in treating 
      both obesity and T2DM, usually after other treatments have failed. This study 
      aims to compare Roux-Y gastric bypass and sleeve gastrectomy in determining early 
      diabetic outcomes in obese Malaysian patients with T2DM following surgery. A 
      total of 172 obese patients with T2DM who were assigned to either laparoscopic 
      Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) were 
      analysed up to a year post-procedure. The patients' T2DM severity were stratified 
      using the Individualized Metabolic Surgery (IMS) score into mild, moderate and 
      severe. Remission rates of diabetes were compared between surgical techniques and 
      within diabetic severity categories. T2DM remission for patients who underwent 
      either surgical technique for mild, moderate or severe disease was 92.9%, 56.2% 
      and 14.7% respectively. Both surgical techniques improved T2DM control for 
      patients in the study. Comparing baseline with results 1 year postoperatively, 
      median HbA1c reduced from 7.40% (IQR 2.60) to 5.80% (IQR 0.80) (p < 0.001), mean 
      total antidiabetic medications use reduced from 1.48 (SD 0.99) to 0.60 (SD 0.86) 
      [p < 0.001], insulin usage reduced from 27.9 to 10.5% (p < 0.001), and T2DM 
      control improved from 27.9 to 82% (p < 0.001). The patients had a median excess 
      BMI loss of 69.4% (IQR 34%) and 53.2% (IQR 36.0%) for RYGB and SG respectively 
      (p = 0.016). At one year following surgery, there is no difference between LRYGB 
      and LSG in terms of diabetic remission. LSG is not inferior to LRYGB in terms of 
      early diabetic outcomes. Milder T2DM shows a better response. LSG is a simpler 
      procedure with a lower risk profile and should be considered as an early 
      treatment option for obese patients with T2DM.
CI  - (c) 2024. The Author(s).
FAU - Pang, Wei Soon
AU  - Pang WS
AD  - Department of Surgery, Pusat Perubatan Universiti Kebangsaan Malaysia, 56000, 
      Kuala Lumpur, Malaysia.
FAU - Loo, Guo Hou
AU  - Loo GH
AD  - Department of Surgery, Pusat Perubatan Universiti Kebangsaan Malaysia, 56000, 
      Kuala Lumpur, Malaysia. looguohou@ukm.edu.my.
FAU - Tan, Guo Jeng
AU  - Tan GJ
AD  - Department of Internal Medicine, Pusat Perubatan Universiti Kebangsaan Malaya, 
      59100, Kuala Lumpur, Malaysia.
FAU - Mardan, Mardiana
AU  - Mardan M
AD  - Department of Surgery, Pusat Perubatan Universiti Kebangsaan Malaysia, 56000, 
      Kuala Lumpur, Malaysia.
FAU - Rajan, Reynu
AU  - Rajan R
AD  - Department of Surgery, Pusat Perubatan Universiti Kebangsaan Malaysia, 56000, 
      Kuala Lumpur, Malaysia.
FAU - Kosai, Nik Ritza
AU  - Kosai NR
AD  - Department of Surgery, Pusat Perubatan Universiti Kebangsaan Malaysia, 56000, 
      Kuala Lumpur, Malaysia.
LA  - eng
PT  - Journal Article
DEP - 20240105
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/complications/surgery
MH  - *Gastric Bypass
MH  - Southeast Asian People
MH  - Gastrectomy
MH  - Obesity/complications/surgery
PMC - PMC10770027
COIS- The authors declare no competing interests.
EDAT- 2024/01/06 10:42
MHDA- 2024/01/08 06:41
PMCR- 2024/01/05
CRDT- 2024/01/05 23:29
PHST- 2023/04/07 00:00 [received]
PHST- 2024/01/04 00:00 [accepted]
PHST- 2024/01/08 06:41 [medline]
PHST- 2024/01/06 10:42 [pubmed]
PHST- 2024/01/05 23:29 [entrez]
PHST- 2024/01/05 00:00 [pmc-release]
AID - 10.1038/s41598-024-51384-1 [pii]
AID - 51384 [pii]
AID - 10.1038/s41598-024-51384-1 [doi]
PST - epublish
SO  - Sci Rep. 2024 Jan 5;14(1):614. doi: 10.1038/s41598-024-51384-1.