Bariatric Surgery Is Superior to Medical Management for Long-Term Diabetes Control

Investigators previously reported pooled 3-year outcomes of four randomized, single-center trials of bariatric surgery or medical management for patients with type 2 diabetes (STAMPEDE, TRIABETES, SLIMM-T2D, and CROSSROADS).^* They now report outcomes during median follow-up of 11 years in 262 patients (mean age, 50; mean body-mass index [BMI], 36 kg/m²). About 80% of patients randomized to surgery underwent Roux-en-Y gastric bypass or sleeve gastrectomy. Those randomized to medical management received various structured programs considered more intense than usual care; one quarter of these patients eventually crossed over to surgery.

Selected results are as follows:

• At 7 years, mean glycosylated hemoglobin (HbA_1c) had decreased by 1.6 percent…