JAMA surgery

Safety and Weight Loss Benefits of Two Stomach Surgery Types for Type 2 Diabetes Across Different Races and Ethnicities

Updated

Abstract

A total of 36,871 patients underwent primary bariatric surgery with mean weight loss differences of 1%-3% across racial and ethnic groups.

  • Roux-en-Y gastric bypass (RYGB) resulted in greater weight loss and HbA1c level reductions than sleeve gastrectomy (SG) for Black, Hispanic, and White patients.
  • Black patients experienced a 5-year weight loss difference of -7.6% with RYGB compared to SG.
  • Hispanic patients had a 5-year weight loss difference of -6.2%, while White patients saw a difference of -5.9% with RYGB.
  • Black and Hispanic patients had a higher risk of hospitalization with RYGB compared to SG, with hazard ratios of 1.45 and 1.48, respectively.
  • Hispanic patients faced a significantly increased risk of all-cause mortality (HR, 2.41) and a higher chance of major adverse events within 30 days (odds ratio, 1.92) with RYGB.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Coleman reported receiving grants from Patient-Centered Outcomes Research Institute (PCORI), the National Institutes of Health (NIH), Janssen, and the US Food and Drug Administration outside the submitted work. Mr Wellman reported receiving grants from PCORI during the conduct of the study. Dr Fitzpatrick reported receiving grants from PCORI and the NIH and financial support (salary) from WW (formerly Weight Watchers). Dr Lewis reported receiving honoraria from National Committee for Quality Assurance (NCQA) for serving as a faculty member on a continuing medical education video about the treatment of obesity outside the submitted work. Dr McTigue reported receiving grants from the University of Pittsburgh research contract from PCORI during the conduct of the study. Dr Tobin reported receiving grants from the NIH National Heart, Lung, and Blood Institute, US Department of Health and Human Services Administration for Community Living, and PCORI during the conduct of the study. Dr Clark reported receiving grants from Johns Hopkins School of Medicine during the conduct of the study. Dr Toh reported receiving grants from PCORI during the conduct of the study. Dr Williams reported receiving grants from PCORI during the conduct of the study. Dr Anau reported receiving grants from PCORI during the conduct of the study. Dr Horberg reported receiving grants from PCORI during the conduct of the study. Dr Michalsky reported receiving honorarium from and being a shareholder of Intuitive Surgical outside the submitted work. Dr Cook reported receiving grants from PCORI, the NIH, and the Centers for Disease Control and Prevention outside the submitted work. Dr Arterburn reported receiving grants from PCORI, the NIH, and Sharecare and receiving travel support from the World Congress for Interventional Therapy for Diabetes and the International Federation for the Surgery of Obesity and Metabolic Disorders Latin America Chapter outside the submitted work. Dr Apovian reported receiving grants from Orexigen, Aspire Bariatrics, GI Dynamics, Myos, Takeda, the Vela Foundation, the Dr. Robert C. and Veronica Atkins Foundation, Coherence Lab, Energesis, the NIH, and PCORI; advisory board fees from Altimmune, Cowen and Company, Gelesis, L-Nutra, NeuroBo Pharmaceuticals, Nutrisystem, Zafgen, Sanofi-Aventis, Orexigen, Novo Nordisk, GI Dynamics, Takeda, Scientific Intake, Pain Script Corporation, Riverview School, Rhythm Pharmaceuticals, Xeno Biosciences, Eisai, EnteroMedics, and Bariatrix Nutrition; and having a previous ownership of stock in Science-Smart outside the submitted work. No other disclosures were reported.
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