Comparative Interventional Study to Evaluate the Role of LRYGBP, LSG & SMM

Inclusion Criteria: * Age 30 to 60 years at the time of enrollment. * Type II DM present according to standard diagnostic criteria (ADA 2010) for at least 6 months. * Body mass Index (BMI) between 27.5 - 32.5 kg / m². * Waist circumference\>90 cm if male; \>80cm if female. * Demonstrated to have inadequate control of diabetes defined as HbA1c \>8.0mg/dl * Patients who have given written informed consent. * Ability to complete the run in for dietary intake and exercise * Willingness and ability to comply with the follow up protocol, including returns to the clinical center for visits at 1, 3, 12, 24, months post surgery. Exclusion Criteria: * TypeII DM of more than 10 years duration. * Weight loss of more than 9Kgs in preceding six months. * Currently pregnant or planning to become pregnant. * Cancer requiring treatment in the past 5 years * Active HIV or tuberculosis * CVD event within 6 months prior to enrollment * Pulmonary embolus in past 6 months * CVD manifesting any of the following criteria: unstable angina pectoris or angina pectoris at rest; a history of cardiac arrest; complex ventricular arrhythmia at rest or with exercise; uncontrolled atrial fibrillation(heart rate of 100 beats per minute or more); New York Heart Association Class III or IV congestive her failure; acute myocarditis, pericarditis or hypertrophic myocardiopathy; clinically significant aortic stenosis; left bundle block or cardiac pace maker unless approved by cardiologist, cardiac defibrillator; history of aortic aneurysum or at least 7cm in diameter or aortic aneurysum repair; resting heat rate\<45 beats per minute or \>100 beats per minute; heart transplantation. * Serum creatinine \>1.4mg/dl(women) or 1.5mg/dl(men) * History of PE or DVT within 6 months * Abnormal serum free T4 (\>1.8) of thryrotropin (TSH \>5.5) * Bilirubin, aspartate amino transferase (AST) or alkaline phosphatase more than thrice the normal. * Hospitalization for depression in past 6 months. * Travel plans that inhibits full participation * History of bariatric surgery, small bowel resection or extensive large bowel resection * Chronic treatment with systematic corticosteroids * Current diagnosis of schizophrenia, or other psychotic disorder, bipolar disorder, alcohol abuse or substance abuse. * Alcoholic or drug addict ( daily consumption of alcohol \>60ml in males and \>30ml in females) * Unstable proliferative retinopathy * Other medical, psychiatric, or behavioral limitations that in the judgments of the investigators may interfere with study participation or the ability to follow the intervention protocol