Roux-en-Y Gastric Bypass Means Greater Weight Loss, Other Improvements in Obese Patients
Main Points:
Obese patients type 2 diabetes (T2DM) who underwent Roux-en-Y gastric bypass (RYGB) surgery had greater weight loss and other sustained improvements compared with intensive medical/weight management of the disease in a clinical trial that further confirmed the feasibility of conducting a larger trial to compare bariatric surgery with other interventions.
Published in:
JAMA Surgery
Author:
Florencia Halperin, M.D., of the Brigham and Women’s Hospital, Boston, and colleagues
Background:
Data support bariatric surgery as a therapeutic strategy to manage T2DM.
How the Study Was Conducted:
Authors tested the feasibility of conducting a larger trial to determine the long-term effect of RYGB compared with intensive medical/weight management in obese patients (body mass index 30 to 42) with T2DM. The trial analyzed data from 38 participants (19 in the RYGB group and 19 in the medical/weight management intervention).
Results:
At one year, more patients in the RYGB group than the medical/weight management group (58 percent vs. 16 percent, respectively) achieved HbA 1c below 6.5 percent and fasting glucose below 126 mg/dL. Other outcomes, including HbA 1c , weight, waist circumference, fat mass, lean mass, blood pressure and triglyceride levels, decreased more and high-density lipoprotein cholesterol increased more after RYGB than the nonsurgical intervention.
Discussion:
“These differences may help inform therapeutic decisions for diabetes and weight loss strategies in obese patients with type 2 diabetes until larger randomized trials are performed.”
Reference:
Florencia Halperin MD, Su-Ann Ding MD, Donald C. Simonson MD, MPH, ScD, Jennifer Panosian BA, Ann Goebel-Fabbri PhD, Marlene Wewalka MD, Osama Hamdy MD, PhD, Martin Abrahamson MD, Kerri Clancy RN, Kathleen Foster RN, David Lautz MD, Ashley Vernon MD, Allison B. Goldfine MD. Roux-en-Y Gastric Bypass Surgery or Lifestyle With Intensive Medical Management in Patients With Type 2 Diabetes: Feasibility and 1-Year Results of a Randomized Clinical Trial. JAMA Surg. 2014;149(7):-. doi:10.1001/jamasurg.2014.514
Editor’s Note:
Authors made conflict of interest disclosures. This work was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and other sources. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Media Advisory:
To contact corresponding author Allison B. Goldfine, M.D., email communications@joslin.harvard.edu.
