In contrast , some RCT data of nonsurgical therapies show benefits at 10 years of follow-up or more .
AND RELEVANCE Current evidence suggests that , when compared with nonsurgical treatments , bariatric surgical procedures in patients with a BMI of 30 to 35 and diabetes are associated with greater short-term weight loss and better intermediate glucose outcomes .
IMPORTANCE Bariatric surgery is beneficial in persons with a body mass index ( BMI ) of 35 or greater with obesity-related comorbidities .
There is interest in using these procedures in persons with lower BMI and diabetes .
OBJECTIVE To assess the association between bariatric surgery vs nonsurgical treatments and weight loss and glycemic control among patients with diabetes or impaired glucose tolerance and BMI of 30 to 35 .
Hyperoxaluric nephrolithiasis is a complication of Roux-en-Y gastric bypass surgery.
Roux-en-Y bypass surgery is the most common bariatric procedure currently performed in the United States for medically complicated obesity . Although this leads to a marked and sustained weight loss , we have identified an increasing number of patients with episodes of nephrolithiasis afterwards . We describe a case series of 60 patients seen at Mayo Clinic-Rochester that developed nephrolithiasis after Roux-en-Y gastric bypass ( RYGB ) , including a subset of 31 patients who had undergone metabolic evaluation in the Mayo Stone Clinic . The mean body mass index of the patients before procedure was 57 kg/m(2 ) with a mean decrease of 20 kg/m(2 ) at the time of the stone event , which averaged 2.2 years post-procedure . When analyzed , calcium oxalate stones were found in 19 and mixed calcium oxalate/uric acid stones in two patients . Hyperoxaluria was a prevalent factor even in patients without a prior history of nephrolithiasis , and usually presented more than 6 months after the procedure . Calcium oxalate supersaturation , however , was equally high in patients less than 6 months post-procedure due to lower urine volumes . In a small r and om sampling of patients undergoing this bypass procedure , hyperoxaluria was rare preoperatively but common 12 months after surgery . We conclude that hyperoxaluria is a potential complicating factor of RYGB surgery manifested as a risk for calcium oxalate stones
In contrast , some RCT data of nonsurgical therapies show benefits at 10 years of follow-up or more .
AND RELEVANCE Current evidence suggests that , when compared with nonsurgical treatments , bariatric surgical procedures in patients with a BMI of 30 to 35 and diabetes are associated with greater short-term weight loss and better intermediate glucose outcomes .
IMPORTANCE Bariatric surgery is beneficial in persons with a body mass index ( BMI ) of 35 or greater with obesity-related comorbidities .
There is interest in using these procedures in persons with lower BMI and diabetes .
OBJECTIVE To assess the association between bariatric surgery vs nonsurgical treatments and weight loss and glycemic control among patients with diabetes or impaired glucose tolerance and BMI of 30 to 35 .