Significantly more patients achieve glycemic control with surgery plus medical therapy than with medication alone
MONDAY, March 26 (HealthDay News) -- For obese patients with uncontrolled type 2 diabetes, bariatric surgery results in significantly improved glycemic outcomes compared with medical therapy alone, according to a study published online March 26 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American College of Cardiology, held from March 24 to 27 in Chicago.
Philip R. Schauer, M.D., from the Cleveland Clinic, and colleagues randomly assigned 150 obese patients with uncontrolled type 2 diabetes (average glycated hemoglobin of 9.2 percent) to medical therapy alone, medical therapy plus Roux-en-Y gastric bypass, or medical therapy plus sleeve gastrectomy.
After one year, the researchers found that glycated hemoglobin levels were 6 percent or less in 12 percent of the medical-therapy group, 42 percent of the gastric-bypass group, and 37 percent of the sleeve-gastrectomy group. In all three groups, glycemic control improved, with mean glycated hemoglobin levels of 7.5 in the medical-therapy group versus 6.4 and 6.6 percent in the gastric-bypass and sleeve-gastrectomy groups, respectively. Mean weight loss was significantly higher in the two surgical groups, at 29.4 kg and 25.1 kg for gastric bypass and sleeve gastrectomy, respectively, compared with 5.4 kg for the medical-therapy group. Patients who underwent surgery had less need for drugs to lower glucose, lipids, and blood pressure, while patients who received medical therapy alone required more drugs.
"In obese patients with uncontrolled type 2 diabetes, 12 months of medical therapy plus bariatric surgery achieved glycemic control in significantly more patients than medical therapy alone," Schauer and colleagues conclude.
The study was funded by Ethicon Endo-Surgery; several authors disclosed financial ties to pharmaceutical and medical technology companies, including Ethicon Endo-Surgery.