Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes

Five-year data showed that among patients with type 2 diabetes and a BMI of 27 to 43, bariatric surgery plus intensive medical therapy was more effective than intensive medical therapy alone in decreasing or resolving hyperglycemia, even among those with a BMI of less than 35. Observational studies...

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Vydáno v:The New England journal of medicine Ročník 376; číslo 7; s. 641 - 651
Hlavní autoři: Schauer, Philip R, Bhatt, Deepak L, Kirwan, John P, Wolski, Kathy, Aminian, Ali, Brethauer, Stacy A, Navaneethan, Sankar D, Singh, Rishi P, Pothier, Claire E, Nissen, Steven E, Kashyap, Sangeeta R
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Massachusetts Medical Society 16.02.2017
Témata:
Adult
Blood Glucose - analysis
Body Mass Index
Body weight
Cholesterol
Cholesterol, HDL - blood
Clinical outcomes
Clinical trials
Combined Modality Therapy
Comparative studies
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - surgery
Drug therapy
Female
Gastrectomy
Gastric Bypass
Gastrointestinal surgery
Glucose
Glycated Hemoglobin A - analysis
Hemoglobin
Humans
Hyperglycemia
Hypoglycemic Agents - therapeutic use
Insulin
Insulin - therapeutic use
Male
Middle Aged
Motivation
Obesity - complications
Obesity - surgery
Surgery
Treatment Outcome
Triglycerides - blood
Cleveland Ohio
United States > US
ISSN:0028-4793, 1533-4406, 1533-4406
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Popis
Shrnutí:Five-year data showed that among patients with type 2 diabetes and a BMI of 27 to 43, bariatric surgery plus intensive medical therapy was more effective than intensive medical therapy alone in decreasing or resolving hyperglycemia, even among those with a BMI of less than 35. Observational studies 1 – 6 and randomized, controlled trials, which have generally been short-term studies, 7 – 19 have shown that bariatric surgery, when used specifically to treat diabetes, significantly improves glycemic control and reduces cardiovascular risk factors. In the Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial, we reported that, at 1 year and 3 years after randomization, both gastric bypass and sleeve gastrectomy were superior to intensive medical therapy alone in achieving excellent glycemic control (i.e., glycated hemoglobin ≤6.0%), reducing cardiovascular risk, improving quality of life, and decreasing medication use. 8 – 10 The current article provides results of the final, 5-year . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1600869