Journal ArticleDOI
Bariatric Surgery Versus Conventional Medical Therapy for Type 2 Diabetes
Geltrude Mingrone,Simona Panunzi,Andrea De Gaetano,Caterina Guidone,Amerigo Iaconelli,Laura Leccesi,Giuseppe Nanni,Alfons Pomp,Marco Castagneto,Giovanni Ghirlanda,Francesco Rubino +10 more
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TLDR
The investigators concluded that bariatric surgery is a potentially beneficial intervention for management of uncontrolled diabetes because it eliminated the need for diabetic medications in some patients and impressively reduced theneed for drug therapy in others.Abstract:
Methods In this single-center, nonblinded, randomized, controlled trial, 60 patients between the ages of 30 and 60 years with a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 35 or more, a history of at least 5 years of diabetes, and a glycated hemoglobin level of 7.0% or more were randomly assigned to receive conventional medical therapy or undergo either gastric bypass or biliopancreatic diversion. The primary end point was the rate of diabetes remission at 2 years (defined as a fasting glucose level of <100 mg per deciliter [5.6 mmol per liter] and a glycated hemoglobin level of <6.5% in the absence of pharmacologic therapy). Results At 2 years, diabetes remission had occurred in no patients in the medical-therapy group versus 75% in the gastric-bypass group and 95% in the biliopancreatic-diversion group (P<0.001 for both comparisons). Age, sex, baseline BMI, duration of diabetes, and weight changes were not significant predictors of diabetes remission at 2 years or of improvement in glycemia at 1 and 3 months. At 2 years, the average baseline glycated hemoglobin level (8.65±1.45%) had decreased in all groups, but patients in the two surgical groups had the greatest degree of improvement (average glycated hemoglobin levels, 7.69±0.57% in the medical-therapy group, 6.35±1.42% in the gastric-bypass group, and 4.95±0.49% in the biliopancreatic-diversion group). Conclusions In severely obese patients with type 2 diabetes, bariatric surgery resulted in better glu cose control than did medical therapy. Preoperative BMI and weight loss did not predict the improvement in hyperglycemia after these procedures. (Funded by Catholic University of Rome; ClinicalTrials.gov number, NCT00888836.)read more
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2013 AHA/ACC/TOS Guideline for the Management of Overweight
Michael D. Jensen,H. Ryan,M. Apovian,Catherine M. Loria,Jamy D. Ard,Barbara E. Millen,Anthony G. Comuzzie,Cathy Nonas,Karen A. Donato,F. Xavier Pi-Sunyer,Frank B. Hu,S. Hubbard,Victor J. Stevens,John M. Jakicic,Thomas A. Wadden,Robert F. Kushner,Bruce M. Wolfe,Susan Z. Yanovski +17 more
Journal ArticleDOI
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Michael D. Jensen,Donna H. Ryan,Caroline M. Apovian,Jamy D. Ard,Anthony G. Comuzzie,Karen A. Donato,Frank B. Hu,Van S. Hubbard,John M. Jakicic,Robert F. Kushner,Catherine M. Loria,Barbara E. Millen,Cathy Nonas,F. Xavier Pi-Sunyer,June Stevens,Victor J. Stevens,Thomas A. Wadden,Bruce M. Wolfe,Susan Z. Yanovski +18 more
TL;DR: This data indicates that overweight and obesity in adults over the age of 40 is more likely to be a risk factor for adverse events than the other factors, including smoking, diet, and physical activity.
Journal ArticleDOI
Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 3-Year Outcomes
Philip R. Schauer,Deepak L. Bhatt,John P. Kirwan,Kathy Wolski,Stacy A. Brethauer,Sankar D. Navaneethan,Ali Aminian,Claire E. Pothier,Steven E. Nissen,Sangeeta R. Kashyap,Abstr Act +10 more
TL;DR: Among obese patients with uncontrolled type 2 diabetes, 3 years of intensive medical therapy plus bariatric surgery resulted in glycemic control in significantly more patients than did medical therapy alone.
Journal ArticleDOI
Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials
Viktoria Gloy,Matthias Briel,Matthias Briel,Deepak L. Bhatt,Sangeeta R. Kashyap,Philip R. Schauer,Geltrude Mingrone,Heiner C. Bucher,Alain J Nordmann +8 more
TL;DR: Compared with non-surgical treatment of obesity, bariatric surgery leads to greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome and greater improvements in quality of life and reductions in medicine use.
Journal ArticleDOI
Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial
Geltrude Mingrone,Geltrude Mingrone,Simona Panunzi,Andrea De Gaetano,Caterina Guidone,Amerigo Iaconelli,Giuseppe Nanni,Marco Castagneto,Stefan R. Bornstein,Francesco Rubino +9 more
TL;DR: Surgery is more effective than medical treatment for the long-term control of obese patients with type 2 diabetes and should be considered in the treatment algorithm of this disease, however, continued monitoring of glycaemic control is warranted because of potential relapse of hyperglycaemia.
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