UNASSIGNED: Background Long-term results from randomized, controlled trials that compare medical therapy with surgical therapy in @entity1 with @entity164 2 @entity6 are limited. Methods We assessed outcomes 5 years after 150 @entity1 who had @entity164 2 @entity6 and a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 27 to 43 were randomly assigned to receive intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy. The primary outcome was a glycated hemoglobin level of 6.0% or less with or without the use of @entity6 medications. Results Of the 150 @entity1 who underwent randomization, 1 @entity1 died during the 5-year follow-up period; 134 of the remaining 149 @entity1 (90%) completed 5 years of follow-up. At baseline, the mean (  SD) age of the 134 @entity1 was 49  8 years, 66% were @entity1 , the mean glycated hemoglobin level was 9.2  1.5%, and the mean BMI was 37  3.5. At 5 years, the criterion for the primary end point was met by 2 of 38 @entity1 (5%) who received medical therapy alone, as compared with 14 of 49 @entity1 (29%) who underwent gastric bypass (unadjusted P=0.01, adjusted P=0.03, P=0.08 in the intention-to-treat analysis) and 11 of 47 @entity1 (23%) who underwent sleeve gastrectomy (unadjusted P=0.03, adjusted P=0.07, P=0.17 in the intention-to-treat analysis). @entity1 who underwent surgical procedures had a greater mean percentage reduction from baseline in glycated hemoglobin level than did @entity1 who received medical therapy alone (2.1% vs. 0.3%, P=0.003). At 5 years, changes from baseline observed in the gastric-bypass and sleeve-gastrectomy groups were superior to the changes seen in the medical-therapy group with respect to body weight (-23%, -19%, and -5% in the gastric-bypass, sleeve-gastrectomy, and medical-therapy groups, respectively), @entity412 level (-40%, -29%, and -8%), high-density lipoprotein @entity165 level (32%, 30%, and 7%), use of @entity2690 (-35%, -34%, and -13%), and quality-of-life measures (general health score increases of 17, 16, and 0.3; scores on the RAND 36-Item Health Survey ranged from 0 to 100, with higher scores indicating better health) (P<0.05 for all comparisons). No major late surgical complications were reported except for one reoperation. Conclusions Five-year outcome data showed that, among @entity1 with @entity164 2 @entity6 and a BMI of 27 to 43, bariatric surgery plus intensive medical therapy was more effective than intensive medical therapy alone in decreasing, or in some cases resolving, @entity4854 . (Funded by Ethicon Endo-Surgery and others; STAMPEDE ClinicalTrials.gov number, NCT00432809 .).

Bariatric Surgery versus Intensive Medical Therapy for XXXX - 5-Year Outcomes.

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'patient'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity2690 :: ('3630', 'Gene') :: ['insulin'] @entity412 :: ('CHEBI:17855', 'Chemical') :: ['triglyceride'] @entity164 :: ('MESH:D017827', 'Disease') :: ['type'] @entity4854 :: ('MESH:D006943', 'Disease') :: ['hyperglycemia'] @entity165 :: ('MESH:D002784', 'Chemical') :: ['cholesterol']
@entity6 :: (MESH:D003920,Disease) :: ['Diabetes']
