Purpose of Technology: Roux-en-Y gastric bypass is a surgery that reduces the capacity of the stomach and the length of the small intestine through which food travels. Sleeve gastrectomy reduces stomach capacity only. These bariatric surgeries are widely accepted as very effective for weight loss in people with morbid obesity; however, recent research has explored their use for the treatment of type II diabetes mellitus.

Rationale: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) bariatric surgeries may improve type II diabetes mellitus (T2DM) by multiple mechanisms, including induction of weight loss and hormonal changes.

Controversy: RYGB has been considered the first choice of metabolic surgery, but it has recently been displaced as the most popular bariatric surgery by SG. Their comparative efficacy for T2DM resolution and comparative safety in patients with T2DM has not been comprehensively characterized.

Relevant Questions:

  • How do RYGB and SG outcomes compare in terms of diabetes remission or improvement and prevention of diabetes-related complications? Do improvements endure long term?
  • What complications are associated with RYGB and SG in patients with T2DM, and how do they compare?
  • Have definitive patient selection criteria been established for RYGB or SG in patients with T2DM?

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