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Longer-Term Follow-Up from a Bariatric Surgery Trial for Diabetic Patients — Physician’s First Watch

Medical News |
April 2, 2014

Longer-Term Follow-Up from a Bariatric Surgery Trial for Diabetic Patients

By Allan S. Brett

The benefits of bariatric surgery in obese diabetic patients persist at 3 years, according to longer-term follow-up from the STAMPEDE trial reported in the New England Journal of Medicine.

Some 150 obese diabetic patients were randomized to intensive medical therapy alone or with surgery. Initially, 1-year results favored Roux-en-Y gastric bypass and sleeve gastrectomy over medical therapy alone. Now, 3-year findings show the benefits persisted: the proportions of patients whose HbA1c levels were 6% or less and who no longer were taking diabetes medications remained higher in the gastric-bypass and sleeve-gastrectomy groups than in the medical-treatment-alone group (35% and 20% vs. 0%).

In addition, quality-of-life scores improved with surgery but not with medical therapy alone.

The key findings here are that the improved glycemic control reported after 1 year persisted at 3 years and that quality of life improved in the surgery groups. But even-longer-term outcomes, including diabetes end-organ complications and late gastrointestinal surgical complications, will be important to track.

Dr. Brett is Editor-in-Chief of NEJM Journal Watch General Medicine, from which this story was adapted.

Reader Comments (1)

PAUL HELMAN North-shore University Health Systems

What was their definition of " intensive medical treatment". If it was based on the scientifically bankrupt "calories in- calories out" paradigm then the study is worthless regards any proper dietary management . To set bariatric surgery up against a "straw man" is rather poor.
Bariatric procedures can work only to the extent that insulin production falls due to reduction carbohydrate availability. It is a rather barbaric way of approaching obesity.

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