Surgery vs Medical Therapy: Which is Best for Type 2 Diabetes?
Surgical therapy for type 2 diabetes is associated with better glycemic control, weight loss, and improvement of other comorbidities in adolescents with severe obesity, according to new findings.
Researchers arrived at this conclusion following a secondary analysis of the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS; n = 242) and Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY; n = 699) consortia. Follow-up lasted 2 years.
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Teen-LABS participants underwent a primary bariatric procedure, while TODAY participants were randomly assigned to treatment with metformin therapy or in combination with rosiglitazone or an intensive lifestyle intervention.
Anthropometric, clinical, and laboratory data were collected from participants in both studies were collected.
Ultimately, 30 participants from Teen-LABS and 63 participants from TODAY were included in the present analysis. Results indicated that, over the course of follow-up, mean hemoglobin A1c concentration decreased from 6.8% to 5.5% among Teen-LABS participants, but increased from 6.4% to 7.8% among TODAY participants.
Furthermore, body mass index decreased by 29% among Teen-LABS participants, but increased by 3.7% among TODAY participants.
The researchers noted that 23% of Teen-LABS participants required a subsequent surgery during follow-up.
“These data support the need for a well-designed, prospective controlled study to define the role of surgery for adolescents with type 2 diabetes, including health and surgical outcomes,” the researchers concluded.
—Christina Vogt
Reference:
Inge TH, Laffel LM, Jenkins TM, et al. Comparison of surgical and medical therapy for type 2 diabetes in severely obese adolescents. JAMA Pediatr. 2018;172(5):452-460. doi:10.1001/jamapediatrics.2017.5763
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