Roux-en-Y Bypass Ups Glycemic Control, Weight Loss in Diabetes

Roux-en-Y Bypass Ups Glycemic Control, Weight Loss in Diabetes
Roux-en-Y Bypass Ups Glycemic Control, Weight Loss in Diabetes

(HealthDay News) – For obese patients with diabetes, gastric bypass is associated with improved control of comorbid risk factors and weight loss in the short term, according to research published in the June 5 issue of the Journal of the American Medical Association.

Sayeed Ikramuddin, MD, from the University of Minnesota in Minneapolis, and colleagues compared Roux-en-Y gastric bypass with lifestyle and intensive medical management for 120 patients with diabetes with hemoglobin A1c of ≥8% and a body mass index (BMI) of 30–39.9kg/m². The researchers found that after 12 months, 49% of the gastric bypass group and 19% of the lifestyle intervention group had achieved the primary end point of achieving comorbid risk factor control (odds ratio, 4.8). In addition, compared with those in the lifestyle intervention group, those in the gastric bypass group required 3 fewer medications and lost 17.5% more of their initial weight.

Melinda Maggard-Gibbons, MD, from Rand Health in Santa Monica, CA, and colleagues conducted a literature review to examine the correlation between bariatric surgery vs. nonsurgical treatment and weight loss and glycemic control among patients with impaired glycemic control or diabetes and a BMI of 30–35kg/m². The meta-analysis included 32 surgical studies, 11 reviews of nonsurgical treatments, and 11 nonsurgical studies. Based on three randomized controlled trials, the researchers found that surgery correlated with greater weight loss and glycemic control than nonsurgical treatment during one to two years of follow-up.

"Evidence is insufficient to reach conclusions about the appropriate use of bariatric surgery in this population until more data are available about long-term outcomes and complications of surgery," Maggard-Gibbons and colleagues write.

Several authors from the first study disclosed financial ties to the pharmaceutical and medical device industries. One author from the second study disclosed financial ties to UpToDate.

Abstract - Ikramuddin
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Abstract - Maggard-Gibbons
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