HealthDay News – The addition of Roux-en-Y gastric bypass to lifestyle-medical management is associated with improved achievement of treatment goals in type 2 diabetes, according to a study published online June 16 in Diabetes Care.

Sayeed Ikramuddin, MD, from the University of Minnesota in Minneapolis, and colleagues randomized 120 adults with BMI of 30.0 to 39.9 kg/m² and hemoglobin A1c (HbA1c) ≥8.0% to 2 treatment arms. All individuals received the lifestyle-medical management intervention for 24 months, while half were randomly allocated to receive gastric bypass in addition.

Researchers found that the triple end point goal was met by 9% and 28% of lifestyle-medical management and gastric bypass patients, respectively (P=.01), at 36 months. At 3 years, the mean HbA1c values were 8.6% and 6.7%, respectively. At 36 months, none of the lifestyle-medical management patients had diabetes remission, while 17% and 19% of gastric bypass patients had full and partial remission, respectively. 


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More medications were used by lifestyle-medical management patients than by gastric bypass patients (mean: 3.8 vs 1.8). Weight loss was 6.3% and 21.0%, respectively (P<.001). More serious or clinically significant adverse events were seen in patients with gastric bypass over 3 years (51 vs 24).

“Gastric bypass is more effective than lifestyle-medical management intervention in achieving diabetes treatment goals, mainly by improved glycemic control,” the authors wrote.

Disclosures: Several authors disclosed financial ties to pharmaceutical and medical device companies, including Covidien, which funded the study.

Reference

Ikramuddin S, Korner J, Lee W-J, et al. Durability of addition of Roux-en-Y gastric bypass to lifestyle intervention and medical management in achieving primary treatment goals for uncontrolled type 2 diabetes in mild-to-moderate obesity: a randomized control trial. Diabetes Care. 2016. doi: 10.2337/dc15-2481.