Effect of gastric bypass versus sleeve gastrectomy on the remission of type 2 diabetes, weight loss, and cardiovascular risk factors at 5 years (Oseberg): secondary outcomes of a single-centre, triple-blind, randomised controlled trial.
Summary
In a triple-blind RCT with 109 adults with obesity and type 2 diabetes, gastric bypass yielded higher 5-year diabetes remission, greater weight loss, and lower LDL cholesterol than sleeve gastrectomy, but increased symptomatic postprandial hypoglycaemia. These secondary outcomes inform procedural choice in metabolic surgery for diabetes.
Key Findings
- Gastric bypass achieved superior 5-year type 2 diabetes remission compared with sleeve gastrectomy.
- Greater weight loss and lower LDL cholesterol were observed after gastric bypass.
- Symptomatic postprandial hypoglycaemia occurred more frequently after gastric bypass.
Clinical Implications
For patients with type 2 diabetes and obesity, gastric bypass may be preferred when prioritizing remission and lipid improvement, with counseling on postprandial hypoglycaemia risk and mitigation strategies.
Why It Matters
Provides long-term, high-quality randomized evidence directly comparing two dominant metabolic surgeries on diabetes remission and cardiometabolic endpoints.
Limitations
- Secondary outcomes analysis; single-centre design may limit generalizability
- Open-label follow-up after 1 year; abstract does not report exact remission rates
Future Directions
Report detailed remission and hypoglycaemia rates, validate multicentrically, and test strategies to reduce postprandial hypoglycaemia after gastric bypass.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Randomized, triple-blind controlled trial with 5-year outcomes (secondary analysis)
- Study Design
- OTHER