This review has been written by angelaj - a WLSInfo moderator - and is a brief interpretation of the research paper for your interest.

Mr Kamal Maharwal reviews an article published in the NEJM in April 2012.

The article her reviews discusses the comparison of conventional diabetes treatment with RNY and gastric sleeves.

The link to the review is here

http://www.webmedcentral.com/article_view/3208?goback=%2Egde_1671957_member_104871668

The original article is here

Schauer, P.R., Kashyap, S.R., Wolski, K., Brethauer, S.A., Kirwan, J.P., Pothier, C.E., Thomas, S., Abood, B., Nissen, S.E. and Bhatt, D.L. (2012) 'Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes', N Engl J Med, March 2012

The review and the article find that weight loss is greater with the RNY than the sleeve and much greater than in the medical intervention group alone. Diabetes resolution was also greater in the RNY group. In fact in the intervention group the use of drugs to control glucose levels, cholesterol and blood pressure increased whereas it was less in the other 2 groups. The measure used to assess for remission was measurement of HbA1c over at least a 2 year period.

Mr Maharwal concludes that the article does include patients with lower BMI than would often be considered for bariatric surgery – and that in effect the surgery was being used for remission of diabetes in obese patients.

He does conclude that more research is needed and that all surgeries were carried out by one very competent surgeon and it may be difficult to replicate this in other centres.

Interestingly he chooses not to review a second article in the same edition comparing remission of diabetes rates in patients on conventional diabetes treatment when compared with an RNY and BPD (bilio- pancreatic diversion) patients. In actual fact when looking at the appendix the comparison is between RNY and a duodenal switch.

That article is

Mingrone, G., Panunzi, S., De Gaetano, A., Guidone, C., Iaconelli, A., Leccesi, L., Nanni, G., Pomp, A., Castagneto, M., Ghirlanda, G. and Rubino, F. (2012) 'Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes', N Engl J Med, March 2012

Again the conclusion is that surgery produces greater remission of diabetes than conventional medication. Resolution ahd been achieved in 75% of RNY patients and 95% of the DS patients. Here the surgery was carried out in 2 centres by different  surgeons.