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 .
Improved acylated ghrelin suppression at 2 years in obese patients with type 2 diabetes: effects of bariatric surgery vs standard medical therapy
Objective : Roux-en-Y gastric bypass ( RYGB ) produces more durable glycemic control than sleeve gastrectomy ( SG ) or intensive medical therapy ( IMT ) . However , the contribution of acylated ghrelin ( AG ) , a gluco-regulatory/appetite hormone , to improve glucose metabolism and body composition in patients with type 2 diabetes ( T2D ) following RYGB is unknown . Design : STAMPEDE ( Surgical Treatment and Medication Potentially Eradicate Diabetes Efficiently ) was a prospect i ve , r and omized controlled trial . Subjects : Fifty-three ( body mass index : 36±3 kg m−2 , age : 49±9 years ) poorly controlled patients with T2D ( HbA1c ( glycated hemoglobin ) : 9.7±2 % ) were r and omized to IMT , IMT+RYGB or IMT+SG and underwent a mixed-meal tolerance test at baseline , 12 , and 24 months for evaluation of AG suppression ( postpr and ial minus fasting ) and beta-cell function ( oral disposition index ; glucose-stimulated insulin secretion × Matsuda index ) . Total/ and roid body fat ( dual-energy X-ray absorptiometry ) was also assessed . Results : RYGB and SG reduced body fat comparably ( 15–23 kg ) at 12 and 24 months , whereas IMT had no effect . Beta-cell function increased 5.8-fold in RYGB and was greater than IMT at 24 months ( P<0.001 ) . However , there was no difference in insulin secretion between SG vs IMT at 24 months ( P=0.32 ) . Fasting AG was reduced fourfold following SG ( P<0.01 ) and did not change with RYGB or IMT at 24 months . AG suppression improved more following RYGB than SG or IMT at 24 months ( P=0.01 vs SG , P=0.07 vs IMT ) . At 24 months , AG suppression was associated with increased postpr and ial glucagon-like peptide-1 ( r=−0.32 , P<0.02 ) and decreased and roid fat ( r=0.38 ; P<0.006 ) . Conclusions : Enhanced AG suppression persists for up to 2 years after RYGB , and this effect is associated with decreased and roid obesity and improved insulin secretion . Together , these findings suggest that AG suppression is partly responsible for the improved glucose control after RYGB surgery
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 .