Intensive medical therapy plus bariatric surgery effective for treating type 2 diabetics, study shows

Among patients with type 2 diabetes, bariatric surgery in addition to intensive medical therapy was more effective than intensive medical therapy alone in decreasing hyperglycemia, according to a study published in The New England Journal of Medicine.

Researchers assessed five-year outcomes for 150 patients who had type 2 diabetes and a body-mass index between 27 and 43. Thirty-eight patients were randomly assigned to receive intensive medical therapy alone; while 49 patients received intensive medical therapy plus Roux-en-Y gastric bypass; and 47 patients received intensive medical therapy plus sleeve gastrectomy.

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Only 134 patients completed the five-year follow-up. The primary outcome was a glycated hemoglobin level of 6 percent or less, with or without the use of diabetes medications.

Here are four insights:

1. Five percent of the intensive medical therapy-only group achieved the primary outcome.

2. Twenty-nine percent of patients who underwent gastric bypass and intensive medical therapy achieved the primary outcome; and 23 percent of those who underwent sleeve gastrectomy and intensive medical therapy reported the same.

3. Patients who underwent surgical procedures had a greater mean percentage reduction in glycated hemoglobin level from baseline, as compared to patients who received medical therapy alone.

4. Researchers reported no major late surgical complications except for one reoperation.

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