Intensive Medical Therapy versus a combination of
Intensive Medical Therapy and Roux-en-Y Gastric Bypass or
Sleeve Gastrectomy in Treating Type 2 Diabetes.
Randomized control trial result
Type 2 Diabetes affects millions of people around the world. The rising prevalence of this Diabetes has prompted scientists to investigate the most effective treatments.
A 2017 research study compared the effects of Intensive Medical Therapy versus a Combination of Intensive Medical Therapy and Roux-en-Y Gastric Bypass or Sleeve Gastrectomy in treating Type 2 Diabetes.
In the study, patients with Type 2 diabetes and a BMI of 27 to 43 were assessed after 5 years of going through treatment. They were randomly assigned to receive either only intensive medical therapy or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy. Of the 134 patients assessed after 5 years of follow-up, the researchers found that patients who underwent surgical procedures had a greater mean percentage reduction from baseline in glycated hemoglobin level than patients who received medical therapy alone.
At the start of the study, the patients assessed were between the ages of 41 and 57 years, and two thirds of them were women. The mean BMI was 37±3.5 and the mean glycated hemoglobin level was 9.2±1.5%. At 5 years follow-up, changes observed in patients in the gastric bypass and sleeve gastrectomy groups were superior to the changes in the medical therapy group with respect to body weight, triglyceride level, high density lipoprotein cholesterol level, use of insulin and quality of life measures.
Specifically, there was a 23% body weight loss in the gastric bypass group, 19% in the sleeve gastrectomy group and 5% weight loss in the intensive medical therapy only group.
For triglyceride levels, the reductions were 40%, 29% and 8% for the three groups respectively. Patients use of insulin also reduced in the three groups by 35%, 34% and 13% respectively.
The general health scores used to determine quality of life, increased by 17 points in the gastric bypass group, 16 points in the sleeve gastrectomy group and only 0.3 points in the medical therapy group. Following these observations, the researchers concluded that among patients with Type 2 diabetes and a BMI of 27 to 43, bariatric surgery plus intensive medical therapy was more effective than intensive medical therapy alone in decreasing, and in some cases resolving, hyperglycemia.