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Abstract Confronted by the fact that 90% of all individuals having T2DM are overweight or obese, the coexistence of T2DM and obesity has got the lion’s share of researcher’s concern. In 2007, the first Diabetes Surgery Summit (DSSI) had reached a consensus including gastrointestinal surgery as an effective tool achieving better T2DM control in obese subjects. This declaration had permitted the terms T2DM surgery and BMS to be coined. The following years have witnessed an increasing body of evidence supporting the benefits of BMS in achieving better glycemic control and decreasing cardio metabolic risk factors in T2DM patients when compared to other therapeutic modalities. The choice of surgical procedure treating both obesity and T2DM should be based on assessment of the risk-to benefit ratio in every patient by weighing the improvement in glycemic control and cardiovascular disease (CVD) risk factors versus long-term hazards of the selected procedure. To date, no operation can be pointed to as the gold standard operation for BMS as not enough RCTs comparing different procedures head-to-head are available. Since its introduction, the efficacy and safety SG+TB have been tested by several studies that suggested long-term results of SG+TB superior to VSG and comparable to that of bypass procedures in terms of weight reduction and resolution of comorbidities but with much less complications especially nutritional deficiencies. |