Sleeve Gastrectomy Versus Medical Management for Remission of Diabetes in Mild to Moderately Obese Patients

Sleeve Gastrectomy vs Medical Management for Remission of Diabetes in Mild to Moderately Obese Patients

The investigators plan to randomize mild to moderately obese (BMI 30-34.9) subjects to medical management (diet, exercise, and best medical therapy) versus sleeve gastrectomy with medical management, with a primary endpoint of diabetes remission (normal fasting glucose, off medications and insulin) at one year. Sleeve gastrectomy (also called greater curvature gastrectomy, vertical sleeve gastrectomy, and sleeve gastroplasty) involves stapled resection of the gastric fundus. Secondary endpoints include weight loss, improvement in hypertension, sleep apnea, c-reactive protein, and fasting lipid profile.

Inclusion Criteria:

• Diabetes mellitus, Type 2
• Body Mass Index (BMI) 30-34.9
• Able to understand and comply with study process

Exclusion Criteria:

• Pregnancy
• Prior bariatric surgery
• Diabetes mellitus, Type 1
• Renal impairment
• Cirrhosis or portal hypertension
• Diabetes secondary to a specific condition
• Recent internal malignancy (<5 years)
• Recent major vascular event
• Drug or alcohol dependence
• Uncontrolled psychiatric disease
• Crippling cardiopulmonary disease
• Prohibitive anatomic features (extensive prior surgery, giant paraesophageal hernia)