Resolution of diabetes, gastrointestinal symptoms, and self-reported dietary intake after gastric bypass versus sleeve gastrectomy: a randomized study

医学 减肥 袖状胃切除术 糖尿病 胃肠病学 2型糖尿病 内科学 随机对照试验 胃分流术 Roux-en-Y吻合术 肥胖 外科 胃切除术 内分泌学 癌症
作者
Anna Laurenius,Ola Wallengren,Aiham Alaraj,Heléne Bertéus Forslund,Anders Thorell,Ville Wallenius,Almantas Maleckas
出处
期刊:Surgery for Obesity and Related Diseases [Elsevier BV]
被引量:2
标识
DOI:10.1016/j.soard.2022.10.019
摘要

There is a lack of randomized studies examining diabetes remission and dietary intake between patients undergoing Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG).To examine longitudinal differences in diabetes resolution, dietary intake, and gastrointestinal (GI) symptoms in patients with obesity and type 2 diabetes (T2D) randomized to either RYGB or SG and according to remission of T2D.Four hospitals in Sweden, 2 of which are university hospitals.Dietary intake and GI symptoms were calculated from questionnaires and morphometric differences between surgical methods and T2D remission were compared using the Student t test, effect size (ES) for parametric parameters, and Mann-Whitney U test for nonparametric parameters.Five years after RYGB or SG there was no significant difference in the rate of remission of T2D between RYGB and SG (43% versus 20%, P = .176). RYGB (n = 19) patients had greater weight loss than SG patients (n = 14) (26.4 [9.5] versus 13.1 [9.6] kg, P < .001), despite reporting higher daily caloric intake (Δ 669 kcal, P = .059, ES .67) and food weight (Δ 1029 g/d, P = .003, ES 1.11). RYGB patients, compared with SG patients, also ate 1 more fruit per day (P = .023). Pooled data showed no differences between patients with and without T2D remission regarding weight loss, but those in remission drank more nonalcoholic drinks and milk.Five years postoperatively, patients randomized to RYGB reported considerably higher food intake compared with SG despite lower body weight. The reason and importance of the higher food intake after RYGB compared with SG needs to be further studied.
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