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Diabetes Obes Metab. 2018 Jul;20(7):1762-1765. doi: 10.1111/dom.13263. Epub 2018 Mar 25.

Five-year long-term clinical outcome after bariatric metabolic surgery: A multi-ethnic Asian population in Singapore.

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Upper Gastrointestinal & Bariatric Surgery, Department of General Surgery, Sengkang General Hospital (SKGH), Singapore.
Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital, Singapore.
Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital and Sengkang General Hospital, Singapore.
Department of Endocrinology, Singapore General Hospital, Singapore.
Health Services Research Unit, Division of Medicine, Singapore General Hospital, Singapore.


Bariatric surgery is an effective treatment for morbid obesity and its metabolic related comorbidities; type 2 diabetes, hypertension and hyperlipidaemia.1 However, the literature is scarce regarding the long-term outcome after bariatric surgery, especially among multi-ethnic Asian populations. Considering the growing number of bariatric metabolic surgeries in Asia, we have attempted to provide a regional perspective on 5-year long-term clinical outcomes post bariatric surgery in Singapore. Between 2010 and 2016, all bariatric operative cases were included, and these comprised: laparoscopic sleeve gastrectomy (LSG), 393; laparoscopic Roux-En-Y gastric bypass (RYGB), 125; laparoscopic mini-gastric bypass (MGB), 43. The primary outcome measure was the percentage of excess weight loss (% EWL) at 6 months, 1, 2, 3, 4 and 5 years, with % remission of type 2 diabetes mellitus (T2DM) at 1 year following LSG (49.7%, 61.2%, 56.1%, 47.8%, 40.8% and 47.3%; 82.2%), RYGB (60.2%, 62.1%, 57.6%, 50.1%, 48.7% and 47.7%; 86.9%) and MGB (58%, 68.1%, 62.7%, 66.2%, 64.0%, 65.2%; 71.9%). In conclusion, MGB and RYGB showed the greatest % EWL at 5 years and are recommended for moderate T2DM. LSG is an effective bariatric operation with a high % EWL up to 2 years, and a high remission rate of mild T2DM. The remission rate of T2DM was equally high in all 3 surgical groups, independent of ethnic differences.


bariatric metabolic surgery, diabetes, mini-gastric bypass, obesity, Roux-en-Y gastric bypass; sleeve gastrectomy; weight loss

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