For individuals with type 2 diabetes (T2D), metabolic surgery is more effective than medical therapy for long-term control, according to a study published in The Lancet. Investigators conducted a 10-year follow-up study of a randomized, controlled trial involving patients with T2D who were randomly assigned to medical therapy, Roux-en-Y gastric bypass (RYGB), or biliopancreatic diversion (BPD). At 10 years, 37.5% of all patients treated surgically maintained diabetes remission. In the intention-totreat population, 10-year remission rates were 5.5%, 50.0%, and 25.0% for medical therapy (one patient went into remission after crossover to surgery), BPD, and RYGB, respectively. During follow-up, 58.8% of the 34 patients who were in remission at 2 years had a relapse of hyperglycemia; however, all those with relapse maintained adequate glycemic control at 10 years. Fewer diabetes-related complications occurred in the RYGB and BPD groups versus the medical therapy group (relative risk, 0.07).
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