Expert opinion on the preoperative medical optimization of adults with diabetes undergoing metabolic surgery

Table 4 Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy, the two most commonly performed bariatric procedures, in patients with diabetes and obesity

	RYGB	LSG	Comments
Type of procedure	Combined malabsorptive and restrictive	Restrictive
Effect on weight loss	+++	+++	Most studies demonstrate comparable weight loss, with slight superiority of RYGB shown in some reports
Remission of diabetes	+++	++	RYGB superior to LSG
Short term glycemic improvement	+++	++	RYGB superior to LSG
Long term glycemic improvement	+++	++	RYGB superior to LSG
Improvement in hypertension	++	+	RYGB superior to LSG
Improvement in dyslipidemia	++	+	RYGB superior to LSG
Improvement in gastroesophageal reflux disease	++	+	RYGB superior to LSG
Postoperative complications	+	+/-	Postoperative complication and reoperation rates less with LSG than RYGB
Long-term nutritional deficiencies	++	+	LSG safer that RYGB

LSG: Laparoscopic sleeve gastrectomy; RYGB: Laparoscopic Roux-en-Y gastric bypass.