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Five-year data comparing bariatric surgery with intensive medical therapy in T2D

The US-based randomised controlled STAMPEDE (Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently) trial compared intensive medical therapy alone with intensive medical therapy plus surgery in 150 people with type 2 diabetes and obesity (BMI, 27–43 kg/m2). Compared with intensive medical therapy alone, the proportion of participants who achieved the primary outcome was greater among those undergoing gastric bypass surgery and among those undergoing sleeve gastrectomy.

By Colin Kenny, GP, Dromore

The study enrolled 150 people with type 2 diabetes and a BMI between 27 and 43 kg/m2 from the Cleveland Clinic Bariatric and Diabetes Outpatient Clinic from December 2006 to January 2011. The aim of the study was to compare medical therapy alone with surgical therapy plus medical therapy for diabetes control. Participants were randomly assigned to one of three groups: medical therapy alone or medical therapy combined with bariatric surgery (either laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy).

The 5-year outcomes data from the study were drawn from 134 participants who completed the follow-up (38 in the medical-therapy-alone group, 49 in the gastric-bypass group and 47 in the sleeve-gastrectomy group). The data showed that, among participants with type 2 diabetes and a BMI of 27 to 43 kg/m2, bariatric surgery plus intensive medical therapy was more effective than intensive medical therapy alone in reducing, or in some cases resolving, hyperglycaemia.

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