Surgery is more effective than conventional medical treatment for the long-term control of obese patients with type 2 diabetes, however, continued monitoring of glycemic control is warranted due to potential relapse of hyperglycemia, according to 5-year, follow-up study of 60 patients randomized to receive either medical treatment (n=20), or surgery by gastric bypass (n=20), or biliopancreatic diversion (n=20). Researchers found:

• 50% of the surgical patients maintained diabetes remission at 5 years, compared with none of the medically-treated patients.

• 53% of the patients who achieved 2-year remission in the gastric bypass group and 37% of patients who achieved 2-year remission in the biliopancreatic diversion group recorded relapse of hyperglycemia.

• 42% of patients who underwent gastric bypass and 68% of patients who underwent biliopancreatic diversion had an HbA_1c concentration of 6.5% or less with or without medication, compared with 27% medically-treated patients.

• Surgical patients lost more weight than medically-treated patients.

Citation: Mingrone G, Panuzi S, DeGaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5-year follow-up of an open-label, single-center, randomized controlled trial. Lancet 2015;386:964-973.