HealthDay News — For obese patients with type 2 diabetes, long-term glycemic control is significantly better with bariatric surgery compared with medical therapy, according to a study in the New England Journal of Medicine.

Philip R. Schauer, MD, from the Cleveland Clinic, and colleagues examined three-year outcomes for two types of bariatric surgery — Roux-en-Y gastric bypass or sleeve gastrectomy — in 150 obese patients with type 2 diabetes (mean age, 48 ± 8 years; mean baseline glycated hemoglobin level, 9.3 ± 1.5%).

At three years, 5% of patients in the medical therapy group had a glycated hemoglobin level of 6% or less, compared with 38% in the gastric-bypass group (P<0.001) and 24% in the sleeve gastrectomy group (P=0.01).

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Compared with the medical-therapy group, the surgical groups had lower use of glucose-lowering medications, including insulin.

The mean percentage reduction in weight from baseline was significantly higher in the gastric-bypass and sleeve-gastrectomy groups versus the medical-therapy group (24.5% ± 9.1% and 21.1% ± 8.9%, respectively, versus 4.2% ± 8.3%; P<0.001 both comparisons).

“Among obese patients with uncontrolled type 2 diabetes, three years of intensive medical therapy plus bariatric surgery resulted in glycemic control in significantly more patients than did medical therapy alone,” the researchers wrote.

This research was published to coincide with presentation at the annual meeting of the American College of Cardiology, held from March 29 to 31 in Washington, D.C.


  1. Schauer PR et al. NEJM. 2014; doi:10.1056/NEJMoa1401329.