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Bariatric Surgery Beats Lifestyle Change for T2DM Remission

At three years, surgical treatments superior to lifestyle intervention alone in obese patients

WEDNESDAY, July 1, 2015 (HealthDay News) -- Three-year outcomes indicate that bariatric surgery is superior to lifestyle intervention alone for inducing remission of type 2 diabetes mellitus (T2DM) in obese patients, according to research published online July 1 in JAMA Surgery.

Anita P. Courcoulas, M.D., M.P.H., of the University of Pittsburgh, and colleagues assessed outcomes at three years for 61 obese patients (women, 82 percent; African American, 21 percent) aged 25 to 55 years with T2DM who were randomly assigned to either an intensive lifestyle weight-loss intervention for one year or surgical treatment (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]). All patients received a low-level lifestyle intervention for the second and third years. The rates of remission of T2DM were compared for the nonsurgical and surgical treatments.

The researchers found that partial or complete remission of T2DM was attained in 40 percent of the RYGB group, 29 percent of the LAGB group, and none of the intensive lifestyle weight-loss intervention group. Reduction from insulin or oral medication use at baseline to no medication use at year three was attained in 65 percent of the RYGB group, 33 percent of the LAGB group, and none of the intensive lifestyle weight-loss intervention group.

"We should consider the use of bariatric (metabolic) surgery in all severely obese patients with T2DM and start a mass treatment, similar to what was done with coronary artery bypass graft more than 50 years ago," writes the author of an accompanying editorial.

Several study authors and the editorialist disclosed financial ties to biomedical companies.

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