title: Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial.
abstract: OBJECTIVE
  To determine the efficacies of 2 weight-reducing operations on diabetic control and the role of duodenum exclusion.
  
  
  METHODS
  Double-blind randomized controlled trial.
  
  
  METHODS
  Department of Surgery of the Min-Sheng General Hospital, National Taiwan University.
  
  
  METHODS
  We studied 60 moderately obese patients (body mass index >25 and <35) aged >30 to <60 years who had poorly controlled type 2 diabetes mellitus (T2DM) (hemoglobin A(1c) [HbA(1c)] >7.5%) after conventional treatment (>6 months) from September 1, 2007, through June 30, 2008. Patients and observers were masked during the follow-up, which ended in 2009, 1 year after final enrollment.
  
  
  METHODS
  Gastric bypass with duodenum exclusion (n = 30) vs sleeve gastrectomy without duodenum exclusion (n = 30).
  
  
  METHODS
  The primary outcome was remission of T2DM (fasting glucose <126 mg/dL and HbA(1c) <6.5% without glycemic therapy). Secondary measures included weight and metabolic syndrome. Analysis was by intention to treat.
  
  
  RESULTS
  Of the 60 patients enrolled, all completed the 12-month follow-up. Remission of T2DM was achieved by 28 (93%) in the gastric bypass group and 14 (47%) in the sleeve gastrectomy group (P = .02). Participants assigned to gastric bypass had lost more weight, achieved a lower waist circumference, and had lower glucose, HbA(1c), and blood lipid levels than the sleeve gastrectomy group. No serious complications occurred in either group.
  
  
  CONCLUSIONS
  Participants randomized to gastric bypass were more likely to achieve remission of T2DM. Duodenum exclusion plays a role in T2DM treatment and should be assessed. Trial Registration clinicaltrials.gov Identifier: NCT00540462 (http://www.clinicaltrials.gov).
authors.affiliation: Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taiwan, Republic of China.
authors.forename: Wei-Jei
authors.initials: WJ
authors.lastname: Lee
authors.forename: Keong
authors.initials: K
authors.lastname: Chong
authors.forename: Kong-Han
authors.initials: KH
authors.lastname: Ser
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Lee
authors.forename: Shu-Chun
authors.initials: SC
authors.lastname: Chen
authors.forename: Jung-Chien
authors.initials: JC
authors.lastname: Chen
authors.forename: Ming-Han
authors.initials: MH
authors.lastname: Tsai
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000601:surgery*; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin