Furthermore , except for certain cardiovascular indicators , bariatric surgery was superior to conventional arms in terms of metabolic secondary parameters ( P < 0.05 ) .
Bariatric surgery is a better therapeutic option for weight loss , irrespective of follow-up duration , surgical techniques and obesity levels
BACKGROUND Bariatric surgery has emerged as a competitive strategy for obese patients .
However , its comparative efficacy against non-surgical treatments remains ill-defined , especially among nonseverely obese crowds .
Preserved Insulin Secretory Capacity and Weight Loss Are the Predominant Predictors of Glycemic Control in Patients With Type 2 Diabetes Randomized to Roux-en-Y Gastric Bypass
Improvement in  type 2 diabetes after Roux-en-Y gastric bypass ( RYGB )  has been attributed partly to weight loss , but mechanisms beyond weight loss remain unclear . We performed an ancillary study to the Diabetes Surgery Study to assess changes in incretins , insulin sensitivity , and secretion 1 year after r and omization to lifestyle modification and intensive medical management ( LS/IMM ) alone  ( n = 34 ) or in conjunction with RYGB  ( n = 34 ) . The RYGB group lost more weight and had greater improvement in HbA1c . Fasting glucose was lower after RYGB than after LS/IMM , although the glucose area under the curve decreased comparably for both groups . Insulin sensitivity increased in both groups . Insulin secretion was unchanged after LS/IMM but decreased after RYGB , except for a rapid increase during the first 30 min after meal ingestion . Glucagon-like peptide 1 ( GLP-1 ) was substantially increased after RYGB , while gastric inhibitory polypeptide and glucagon decreased . Lower HbA1c was most strongly correlated with the percentage of weight loss for both groups . At baseline , a greater C-peptide index and 90-min postpr and ial C-peptide level were predictive of lower HbA1c at 1 year after RYGB . β-Cell glucose sensitivity , which improved only after RYGB , and improved disposition index were associated with lower HbA1c in both groups , independent of weight loss . Weight loss and preserved β-cell function both predominantly determine the greatest glycemic benefit after RYGB
Furthermore , except for certain cardiovascular indicators , bariatric surgery was superior to conventional arms in terms of metabolic secondary parameters ( P < 0.05 ) .
Bariatric surgery is a better therapeutic option for weight loss , irrespective of follow-up duration , surgical techniques and obesity levels
BACKGROUND Bariatric surgery has emerged as a competitive strategy for obese patients .
However , its comparative efficacy against non-surgical treatments remains ill-defined , especially among nonseverely obese crowds .