Background 
Sleeve gastrectomy with transit bipartition (SG + TB) procedure was designed to minimize mechanical restriction and malabsorption, aiming to essentially induce metabolic changes. Previous studies have demonstrated good results of SG + TB in regarding weight loss and diabetes remission
Methods:
A prospective, randomized (1:1) and controlled trial to compare the SG+TB with standard medical therapy (SMT) in 20 mildly obese (28-35 kg/m2) T2D patients with Metabolic Syndrome. Before, HbA1c level was > 8%, in spite of intensive treatment, including exogenous insulin
Results
At 3 months, SG+TB group showed a marked increase in FGF-19 levels (74.1 ± 45.8 to 237.3 ± 234 pg/mL; P = 0.001). At 24 months, HbaA1c were < 6.0% present in 9/10 in the SG+TB group compared with 1/10 in SMT. BMI values were lower in the SG+TB group (25.3 ± 2.8 kg/m2 versus 30.9 ± 2.5 kg/m2; P = <0.001). The area under the curve (AUC) of GLP1 increased and in the SG+TB group and the AUC of the GIP concentrations was lower, compared to the SMT group. HDL-cholesterol levels increased just in the SG+TB group (33 ± 8 mg/dL to 45 ± 15 mg/dL, P < 0.001). In SG+TB group, after 4 years, no one patient needed medications for hyperlipidemia or for arterial hypertension; all (100%) are free of exogenous insulin; just 2/10 take metformin for T2D and 9/10 (90%) remain with HbA1c <6%. There were no surgical complications and no significant nutritional problems
Conclusions:
Prospective study confirms the retrospective data, showing SG+TB as a very potent procedure to induce T2D remission and improvement in cardiovascular variables, without any digestive segment exclusions

05 - TRANSIT BIPARTITION: VERY HIGH TYPE 2 DIABETES REMISSION RATE, WITH MINIMAL ADVERSE EFFECTS. A 4-YEAR FOLLOW-UP OF A RANDOMIZED CONTROLED TRIAL