Comparing Glycemic Control and Weight Loss in Diabetic Patients After Sleeve Gastrectomy and RYGB

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is known for its weight-independent glycemic control as opposed to laparoscopic sleeve gastrectomy (LSG). We aim to compare the glycemic control and postoperative total body weight loss (%TBWL) between the two procedures. Methods: Data was collected from a prospectively maintained database, without overlapping LRYGB and LSG timeframes to reduce selection bias. Both surgeries were performed by one surgeon. Demographics, % HbAlc, and %TBWL were collected at 1-year and 2-year postoperatively. Results: There were 229 LRYGB and 124 LSG patients. 15.3% and 57.3% (p < 0.0001) were Hispanics in LRYGB and LSG groups, respectively. LRYGB versus LSG groups: The initial BMI was 47.4 ± 8.6 kg/m2 versus 44.3 ± 7.0 kg/m2 (p = 0.001). The 1-year postoperative %TBWL was 35.6 ± 8.5% versus 27.8 ± 9.5% (p < 0.0001) and 2-year postoperative %TBWL was 32.7 ± 8.4% versus 22.3 ± 11.0% (p < 0.0001). The preoperative %HbAlc was 6.7 ± 1.3 versus 7.0 ± 1.7 and 1-year postoperative %HbAlc was 5.6 ± 0.8 versus 5.6 ± 0.7 (p > 0.05). Conclusions: Despite a higher 1-year %TBWL after LRYGB, the 1-year postoperative HbAlc was similar after both procedures.