Roux-en-Y gastric bypass and sleeve gastrectomy more effectively treated type 2 diabetes in obese patients compared with intensive medical therapy, according to data from a recent study.
Researchers monitored 150 patients in a single-center, nonmasked, randomized trial. All patients had uncontrolled type 2 diabetes with an average baseline glycated hemoglobin level of 9.2±1.5%. Patients were divided into three 50-patient groups to receive either medical therapy, a combination of medical therapy and gastric bypass surgery, or a combination of medical therapy and sleeve gastrectomy. A primary endpoint was the proportion of patients with a glycated hemoglobin level of ≤6.0% 12 months after treatment.
The proportions of patients who met the primary endpoint were 12% in the medical-therapy group, 42% (P=.002) in the gastric bypass combination group, and 37% (P=.008) in the sleeve-gastrectomy combination group. Glycemic control improved in all groups at 12 months, with mean glycated hemoglobin levels of 7.5±1.8% in the medical-therapy group, 6.4±0.9% (P,.001) in the gastric-bypass group, and 6.6±1.0% (P=.003) in the sleeve-gastrectomy group.
“ … obese patients with poorly controlled diabetes who underwent either gastric bypass or sleeve gastrectomy were significantly more likely to achieve a glycated hemoglobin level of 6.0% or less in 12 months after randomization than were patients receiving medical therapy alone,” the researchers said.
Although the study was limited by the “relatively short duration of follow-up [12 months],” researchers wrote, “bariatric surgery represents a potentially useful strategy for management of uncontrolled diabetes, since it has been shown to eliminate the need for diabetes medications in some patients and to markedly reduce the need for drug treatment in others.”