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 .
Adjustable Gastric Band Surgery or Medical Management in Patients With Type 2 Diabetes: A Randomized Clinical Trial.
CONTEXT Recommendations for surgical , compared with lifestyle and pharmacologically based , approaches for type 2 diabetes ( T2D ) management remain controversial . OBJECTIVE The objective was to compare laparoscopic adjustable gastric b and ( LAGB ) to an intensive medical diabetes and weight management ( IMWM ) program for T2D . DESIGN This was design ed as a prospect i ve , r and omized clinical trial . SETTING The setting was two Harvard Medical School-affiliated academic institutions . INTERVENTIONS AND PARTICIPANTS : A 12-month r and omized trial comparing  LAGB ( n = 23 ) vs  IMWM ( n = 22 ) in persons aged 21 - 65 years with body mass index of 30 - 45 kg/m(2 ) , T2D diagnosed more than 1 year earlier , and glycated hemoglobin ( HbA(1c ) ) ≥ 6.5 % on antihyperglycemic medication(s ) . MAIN OUTCOME MEASURE The proportion meeting the prespecified primary glycemic endpoint , defined as HbA(1c ) < 6.5 % and fasting glucose < 7.0 mmol/L at 12 months , on or off medication . RESULTS After r and omization , five participants did not undergo the surgical intervention . Of the 40 initiating intervention ( 22 males/18 females ; age , 51 ± 10 y ; body mass index , 36.5 ± 3.7 kg/m(2 ) ; diabetes duration , 9 ± 5 y ; HbA(1c ) , 8.2 ± 1.2 % ; 40 % on insulin ) , the proportion meeting the primary glycemic endpoint was achieved in 33 % of the LAGB patients and 23 % of the IMWM patients ( P = .457 ) . HbA(1c ) reduction was similar between groups at both 3 and 12 months ( -1.2 ± 0.3 vs -1.0 ± 0.3 % ; P = .496 ) . Weight loss was similar at 3 months but greater 12 months after LAGB ( -13.5 ± 1.7 vs -8.5 ± 1.6 kg ; P = .027 ) . Systolic blood pressure reduction was greater after IMWM than LAGB , whereas changes in diastolic blood pressure , lipids , fitness , and cardiovascular risk scores were similar between groups . Patient-reported health status , assessed using the Short Form-36 , Impact of Weight on Quality of Life , and Problem Areas in Diabetes , all improved similarly between groups . CONCLUSIONS LAGB and a multidisciplinary IMWM program have similar 1-year benefits on diabetes control , cardiometabolic risk , and patient satisfaction , which should be considered in the context of other factors , such as personal preference , when selecting treatment options with obese T2D patients . Longer duration studies are important to underst and emergent differences
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 .