Efficacy of Different Procedures of Metabolic Surgery for Type 2 Diabetes in Asia: a Multinational and Multicenter Exploratory Study

Shih Chiang Shen, Wei Jei Lee, Kazunori Kasama, Yosuke Seki, Yen Hao Su, Simon Kin Hung Wong, Yu Min Huang, Weu Wang

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Introduction: Asian patients with diabetes exhibit different characteristics from Western patients. However, limited large-scale data are available on metabolic surgery procedures in Asia. We compared the short-term efficacies of metabolic surgery procedures for the management of Asian patients with different severities of diabetes. Methods: We included patients undergoing metabolic surgery in five Asian institutions from January 2008 to December 2015 with at least 1-year postoperative follow-up. Outcomes of weight loss and diabetes control were determined. Diabetes remission rates in different ABCD scores and factors affecting diabetes remission were analyzed. Results: A total of 1016 patients (mean BMI, 39.0 ± 7.2 kg/m2; HbA1c, 8.3% ± 1.7%) underwent metabolic surgery (197, Roux-en-Y gastric bypass [RYGB]; 171, one anastomosis gastric bypass [OAGB]; 437, sleeve gastrectomy [SG]; 130, SG with duodenal-jejunal bypass [SG-DJB]; and 81, single anastomosis duodenal-jejunal bypass with SG [SA-DJBSG]). The OAGB group exhibited significantly higher 1-year total weight loss (30.5%) and type 2 diabetes mellitus (T2DM) remission (78.4%) rates than did the other groups (p <.001). The patients with higher preoperative ABCD scores exhibited higher T2DM remission rates (81.8–100% and 9.5–46.2% in ABCD score subgroups of 9–10 and 1–2, respectively). In multivariate analysis, bypass was found to be an independent predictor of T2DM remission compared with SG (odds ratio of OAGB vs SG, 3.72; RYGB vs SG, 1.96; SG-DJB vs SG, 2.73; SA-DJBSG vs SG, 2.12). Conclusion: The metabolic surgeries are highly effective in T2DM treatment. However, SG may not be as effective as gastric bypass and duodenal-jejunum bypass.

Original languageEnglish
Pages (from-to)2153-2160
Number of pages8
JournalObesity Surgery
Issue number5
Publication statusAccepted/In press - 2021


  • Metabolic surgery
  • One anastomosis gastric bypass
  • Predicting diabetes remission
  • Roux-en-y gastric bypass
  • Sleeve gastrectomy
  • Sleeve gastrectomy with duodenal-jejunal bypass

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


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