1. After 7 and 12 years of follow-up, excellent glycemic control was achieved after bariatric surgery for type 2 diabetes management (T2D) in obese patients compared with medical and lifestyle management.
2. The group that underwent bariatric surgery also used fewer diabetes medications and had higher rates of diabetes remission.
Evidence evaluation level: 1(wonderful)
research summary: T2D It is a widespread and costly condition worldwide. Limited evidence suggests that bariatric surgery may be superior to other treatments for type 2 diabetes, but this surgery is usually limited to patients with the following symptoms: I am. body mass index (BMI) Due to research limitations, few people over 35 choose surgery. Additionally, some drugs mimic the weight loss effects of surgery, but they are expensive, lack evidence of long-term efficacy, and require continued use to maintain weight loss. The results of previous studies show that bariatric surgery remains superior in achieving and maintaining it. T2D remission, but this research offered Extended tracking data 7 and 12 years since randomization. In this study, Randomized Medical Trials Alliance vs. Metabolic surgery in type 2 diabetes (ARMMS-T2D) The consortium analyzed data from four single-center randomized trials in the United States to assess the long-term efficacy, durability, and safety of bariatric surgery compared with medical surgery. and Lifestyle treatment for type 2 diabetes, make it The largest and most extensive tracking analysis ever. What we found in this research is that ccompared to medicaland Lifestyle interventions and bariatric surgery have resulted in better glycemic control, reduced use of antidiabetic drugs, and improved diabetes remission rates. One of the study's limitations was the inconsistencies in the original trial protocol and the lack of consistent assessment of specific diabetic complications, such as retinopathy.This discrepancy may affect the reliability of the findings. As conclusion, The results of this study, together with existing evidence, demonstrate the use of bariatric surgery as an effective therapeutic approach to manage obesity. T2D in obese people.
Click to read the study Japan Automobile Manufacturers Association
Click to readaccompanying editorials in Japan Automobile Manufacturers Association and JAMA surgery
Related books: Lifestyle interventions and medical management with and without Roux-en-Y gastric bypass in the Diabetes Surgery Study, 5-year control of hemoglobin A1c, LDL cholesterol, and systolic blood pressure
in-depth [randomized controlled trial]: This research Pooled analysis from four US single-center randomization The study was conducted from May 2007 to August 2013 and observations were made Follow-up until July 2022.The study population includes: individuals with diagnosis of T2DBMI 27-45, And their ages range from 18 to 65. The primary outcome measured the difference in HbA1c percentage change between groups over 7 years, with up to 12 years of additional data available for patients who reached that point before the end of the study. Secondary outcomes assessed changes in HbA1c levels over time, achievement of HbA1c <7.0%, and diabetes remission criteria. Despite starting from higher initial values, patients in the bariatric surgery group consistently maintained significantly lower HbA1c levels compared to the medical/lifestyle group throughout the study period (P < 0.001). By year 7, mean HbA1c decreased from 8.2% to 8.0% at baseline (difference, 0.2% [95% confidence interval (CI), −0.5% to 0.2%]) In the medical/lifestyle group, it decreased from 8.7% to 7.2% in the bariatric surgery group (difference of 1.6%) [95% CI, −1.8% to −1.3%]). In the seventh year, Diabetes Remission rates were 6.2% in the medical/lifestyle group and 18.2% in the bariatric surgery group (odds ratio 3.4 [95% CI, 1.3-9.2]; P = 0.02), and this difference remained statistically significant after 12 years (P < 0.001). Diabetic drug use was similar between both groups at baseline; Significant changes over time in medical/lifestyle groups (P = 00.19 in the 7th year and 0.12 in the 12th year). However, in contrast, drug use rates significantly decreased in the bariatric surgery group from 97.6% at baseline to 38.0% at 1 year and remained significantly lower compared to baseline during follow-up (7 60.5% in the 7th year, 38.0% in the 1st year). P < 0.001).
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