THURSDAY, Feb. 29, 2024 (HealthDay News) — For patients with type 2 diabetes, glycemic control is superior with bariatric surgery versus medical/lifestyle intervention after seven to 12 years of follow-up, according to a study published online in the Feb. 27 issue of the Journal of the American Medical Association.

Anita P. Courcoulas, M.D., from the University of Pittsburgh, and colleagues examined long-term glycemic control and safety of bariatric surgery versus medical/lifestyle management of type 2 diabetes in a pooled analysis of four U.S. single-center randomized trials (262 participants).

Overall, 25 percent of participants randomly assigned to medical/lifestyle management underwent bariatric surgery during follow-up. The researchers found that hemoglobin A1c decreased by 0.2 and 1.6 percent in the medical/lifestyle and bariatric surgery groups, respectively, at seven years, from a baseline of 8.2 and 8.7 percent. The between-group difference was −1.4 and −1.1 percent at seven and 12 years, respectively. In the bariatric surgery group, fewer antidiabetes medications were used. Diabetes remission occurred in more patients after bariatric surgery than after medical/lifestyle management at seven years (18.2 and 6.2 percent, respectively) and at 12 years (12.7 and 0.0 percent, respectively). Four deaths occurred (two in each group), and no differences were seen in major cardiovascular adverse events. After bariatric surgery, anemia, fractures, and gastrointestinal adverse events were more common.

“At seven years and up to 12 years of follow-up from randomization, bariatric surgery was more effective and resulted in long-term improvement for glycemic control while using fewer medications and weight loss,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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