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01-03-2012 | Clinical Research

Efficacy of the Roux-en-Y Gastric Bypass Compared to Medically Managed Controls in Meeting the American Diabetes Association Composite End Point Goals for Management of Type 2 Diabetes Mellitus

Authors: Daniel B. Leslie, Robert B. Dorman, Federico J. Serrot, Therese W. Swan, Todd A. Kellogg, Gonzalo Torres-Villalobos, Henry Buchwald, Bridget M. Slusarek, Barbara K. Sampson, John P. Bantle, Sayeed Ikramuddin

Published in: Obesity Surgery | Issue 3/2012

Abstract

Background

The treatment goals recommended by the American Diabetes Association (ADA) for patients with type 2 diabetes mellitus include hemoglobin A1c (HbA1C) <7.0%, low-density lipoprotein (LDL) <100 mg/dL, and systolic blood pressure (SBP) <130 mmHg. Only 10% of conventionally treated patients reach these goals as a composite endpoint. The efficacy of the Roux-en-Y gastric bypass (RYGB) in meeting this composite endpoint has not been reported.

Methods

We compared our database of patients with type 2 diabetes undergoing RYGB to a database of patients with medically managed type 2 diabetes and at least 2 years of follow-up data.

Results

Ultimately, 152 RYGB patients were compared to 115 routine medical management (RMM) patients for whom data on the composite endpoint were available over 2 years. The results show significant decrease in body mass index (kilograms per square meter) in the RYGB group compared to the RMM group (P < 0.001). HbA1C, LDL cholesterol, and SBP all significantly improved in the RYGB group (all P ≤ 0.01) and did not demonstrate any significant change in the RMM group. Over 2 years, when evaluating all three endpoints, the RYGB group (10.5% to 38.2%, P < 0.001) demonstrated increased achievement of the ADA goals compared to the RMM group (13.9% to 17.4%, P = 0.47). There was a significant decrease in medication use in the RYGB cohort; however, discontinuation of medications was sometimes inappropriate.

Conclusions

RYGB achieves the ADA composite endpoint more frequently than conventional therapy and with less medication.

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Title: Efficacy of the Roux-en-Y Gastric Bypass Compared to Medically Managed Controls in Meeting the American Diabetes Association Composite End Point Goals for Management of Type 2 Diabetes Mellitus
Authors: Daniel B. Leslie
Robert B. Dorman
Federico J. Serrot
Therese W. Swan
Todd A. Kellogg
Gonzalo Torres-Villalobos
Henry Buchwald
Bridget M. Slusarek
Barbara K. Sampson
John P. Bantle
Sayeed Ikramuddin
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Obesity Surgery / Issue 3/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-011-0494-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Efficacy of the Roux-en-Y Gastric Bypass Compared to Medically Managed Controls in Meeting the American Diabetes Association Composite End Point Goals for Management of Type 2 Diabetes Mellitus

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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