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
Primary result · T2D remission (HbA1c ≤6.0%)Result — go to the resultRisk difference 29.5% 95% CI 10.8–48.3Authors' conclusion
Gastric bypass was superior to sleeve gastrectomy regarding long-term remission of type 2 diabetes, weight loss, and LDL cholesterol concentrations, at the expense of a higher frequency of symptomatic postprandial hypoglycaemia. These findings could inform clinical practice and future guidelines regarding the preferred surgical procedure in patients with type 2 diabetes.
Study context
- Population
- Adults (≥18 years) with T2D and obesity at a public tertiary obesity centre in Norway; mean age 47.7 years (SD 9.6), mean BMI 42.3 kg/m² (SD 5.3), 66% women93 completed 5-y follow-up
- Participants
- 109 adults
- Comparison
- Laparoscopic gastric bypass vs sleeve gastrectomy
- Gastric bypassn = 54
- Sleeve gastrectomyn = 55reference
- Primary endpoint
- T2D remission (key secondary outcome of the trial)
- Follow-up
- 5 years after surgery
Methodological detailstwo-armed, single-centre, triple-blind, masked until 1 year after surgery, then open label
- Two-armed
- Single-centre
- Triple-blind
- Masked until 1 year after surgery, then open label
Primary result
T2D remission (HbA1c ≤6.0%) · 5 years
Risk difference
29.5%
95% CI 10.8–48.3
Events by treatment group
Gastric bypassvs Sleeve gastrectomy
risk difference 29.5% (95% CI 10.8–48.3)
As reported in the abstract
Secondary outcomes
| Outcome | Gastric bypass | Sleeve gastrectomy | Risk difference (CI) | |
|---|---|---|---|---|
| T2D remission (HbA1c <6.5%) · 5 years | 63% | 30% | 33.5% (14.1–52.9) | |
| −50050100Difference (linear scale) |
Mean, %
| Outcome | Gastric bypass | Sleeve gastrectomy | Treatment difference (%) (CI) | |
|---|---|---|---|---|
| Bodyweight loss · 5 yearsGreater loss with gastric bypass | 22.2 (95% CI 20.3–24.1) | 17.2 (CI 15.3–19.1) | 5.0 (2.4–7.7) | |
| −50510Difference, % (linear scale) |
| Outcome | Treatment difference (mmol/L) (CI) | |
|---|---|---|
| LDL-C · 5 years | −0.5 (−0.8 to −0.1) | |
| −1−0.500.5Difference, mmol/L (linear scale) |
Safety
| Outcome | Risk difference (CI) | |
|---|---|---|
| Pathological acid reflux · 5 yearsMore frequent with sleeve gastrectomy | 51.1% (28.0–74.2) | |
| −50050100Difference (linear scale) |
Symptomatic postprandial hypoglycaemia · 5 years
Erosive oesophagitis and Barrett's oesophagus · 5 years
- Prevalence similar between groups
Original publication
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. Lancet Diabetes Endocrinol. Published 1 April 2025. doi:10.
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