Comparative Study between Effect of Sleeve Gastrectomy and Mini-Gastric Bypass on Type 2 Diabetes Mellitus

Abstract
Background: Severe obesity (most often defined as a BMI ³35kg/m2 with comorbid health conditions or a BMI ³40 kg/m2 without such conditions) is a highly prevalent chronic disease, which leads to substantial morbidity, premature mortality, impaired quality of life and excess healthcare expenditures. Bariatric surgery leads to greater weight loss and higher remission rates of type II diabetes and greater reductions in use of anti-diabetic drugs compared with non-surgical treatment for obesity.
Aim of Study: The aim of this study is to compare between the effect of sleeve gastrectomy and mini-gastric bypass on patients with type 2 DM and BMI ³35kg/m2.
Patients and Methods: A prospective comparative study which included 40 obese patients with type 2 DM (20 patients were operated for Laparoscopic Sleeve Gastrectomy (LSG) and 20 patients for Laparoscopic Mini-Gastric Bypass (LM-GB), with mean age at LSG group 42.95±7.63 with range of 31-59 years, at LMGB group was 42.9±6.17 with range of 34-58 years.
Results: In SG cases; complete remission occurred in 11 patients with percentage of 55% and failure of remission occurred in 9 patients with percentage of 45%. No cases developed partial remission in SG cases. In MGB cases; 15 developed diabetic remission with percentage of 75% (11 (55%) patients developed complete remission, 4 (20%) patients developed partial remission). Failure of remission occurs in 5 patients in MGB cases with percentage of 25%.
Conclusion: Based on our results, LSG and LMGB are efficient operations for reducing weight in morbidly obese patients and also in diabetic control in T2DM. LMGB might be superior to LSG in %EWL and T2DM remission after 1.5 year follow-up.