Bariatric surgery improvements in type 2 diabetes persist at 5 years

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Takeaway

  • Bariatric surgery is a durable option for treating type 2 diabetes (T2D).

Why this matters

  • T2D incurs high morbidity and costs.

Study design

  • Outcomes assessed at 5 y for 134 patients with T2D with baseline BMI 27-43 kg/m2, randomly assigned to intensive medical therapy alone or combined with either Roux-en-Y gastric bypass or sleeve gastrectomy.
  • Funding: Ethicon Endo-Surgery, LifeScan, Cleveland Clinic, and NIH.

Key results

  • Primary outcome, HbA1c ≤6.0% at 5 y without medication use, achieved in 5% of 38 in medical therapy group vs 29% of 49 with gastric bypass and 23% of 47 with sleeve gastrectomy (P=.03).
  • Diabetes duration <8 y and random assignment to gastric bypass alone were the only significant predictors of achieving HbA1c ≤6.0% (P=.007 and P=.03, respectively).
  • After 5 y, patients in the surgery groups were significantly more likely to achieve HbA1c ≤6.0% without diabetes med...