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Because gastric bypass and other forms of bariatric surgery lower risk for diabetes and cardiovascular-related mortality in morbidly obese patients, attention now has focused on nonmorbidly obese patients with diabetes. Results of a recent randomized trial and a systematic review suggest potential benefits, but many uncertainties remain.
In a trial conducted in the U.S. and China, 120 adults (mean age, 49; mean body-mass index, 35 kg/m2) with uncontrolled diabetes were randomized to Roux-en-Y gastric bypass surgery or intensive medical management consisting of 30 diet and exercise counseling sessions during 12 months. Surgery patients received usual lifestyle-modification counseling and postoperative eating guidance. Most enrollees also were…