Patients who underwent ESG also had an overall reduced metabolic disease burden, with a reduced prevalence of sleep apnea (17.6% ESG vs. 35.0% LSG; p < 0.0001), insulin and medication-dependent diabetes (12.4% ESG vs. 20.6% LSG; p < 0.0001), hypertension (30.8% ESG vs. 42.0% LSG; p < 0.0001), and dyslipidemia (14.4% ESG vs. 20.9% LSG; p < 0.0001). This evidence concerns the gene INS and metabolic disease.