Hello,
First of all, congratulations on your choice to proceed with surgery. It takes a lot of courage to make the decision you have made. The latest literature suggests that patients have similar resolution of diabetes with both the sleeve and and the gastric bypass. Resolution of diabetes is a little less with the band. The latest numbers are like 80% resolution with bypass, 73% resolution with sleeve, and 65% resolution with the band. The first two numbers are not statistically significant.

In my practice, I see similar resolution of diabetes with all 3 operations. We try to take a multidisciplinary approach to weight loss and focus on more than just the operation. We teach our patients how to eat right and exercise, and we have robust support and nutritional groups. We see many of our patients coming off their diabetes medicine before they even reach the operating room.

When you take all the above into consideration, I would not make the decision on which operation to get based on its chances of curing diabetes. The much more important differences between the sleeve and the bypass are that the bypass carries a higher risk of vitamin and iron deficiency than the sleeve, but the bypass patients, on average, lose more weight. Sleeve patients seem to enjoy better hunger suppression than bypass patients, but the sleeve offers no protection against sweets and crunchy carbs, whereas the bypass will not allow the absorption of those calories in the initial postoperative phases. Patients that take a lot of non-steroidal anti-inflammatories (like motrin or advil) should avoid the gastric bypass and consider the sleeve instead, as the latter carries a lower risk of gastric ulcer formation after surgery.

Both the sleeve and the bypass carry similar operative risks, and the risk of the operation should not be a deciding factor between the two. It is possible that you enter the operating room expecting a sleeve, but for technical reasons, your surgeon may not be able to complete that operation and will convert you to a bypass. I consent all my sleeve patients for that possibility that they wake up with a gastric bypass.

So, to specifically answer your question, both operations have similar abilities to cure diabetes, with the bypass perhaps having a slightly higher cure rate.

Good luck,
Dr Dan