PMID- 22000180
OWN - NLM
STAT- MEDLINE
DCOM- 20111202
LR  - 20221207
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 150
IP  - 4
DP  - 2011 Oct
TI  - Comparative effectiveness of bariatric surgery and nonsurgical therapy in adults 
      with type 2 diabetes mellitus and body mass index <35 kg/m2.
PG  - 684-91
LID - 10.1016/j.surg.2011.07.069 [doi]
AB  - BACKGROUND: Outcomes of bariatric surgery in patients with a body mass index 
      (BMI) <35 kg/m(2) have been an active area of investigation. We examined the 
      comparative effectiveness of Roux-en-Y gastric bypass (RYGB) to routine medical 
      management (nonsurgical controls; NSCs) in achieving appropriate targets defined 
      by the American Diabetes Association for type 2 diabetes mellitus (T2DM) in 
      patients with class I obesity (BMI 30.0-34.9 kg/m(2)) T2DM at 1 year. METHODS: We 
      identified patients undergoing RYGB (N = 17) with both class I obesity and T2DM 
      and compared them to similar NSC (N = 17) treated in the Primary Care Center. 
      Data were collected at baseline and 1 year for systolic blood pressure (SBP), as 
      well as blood levels for low-density lipoprotein (LDL) cholesterol and hemoglobin 
      A1c (HbA1c). RESULTS: After RYGB, BMI decreased from 34.6 +/- 0.8 kg/m(2) to 25.8 +/- 
      2.5 kg/m(2) (P < .001) and HbA1c decreased from 8.2 +/- 2.0% to 6.1 +/- 2.7% (P < 
      .001). The NSC cohort had no significant change in either BMI or HbA1c. SBP and 
      LDL did not significantly change in either group. The RYGB group had a decrease 
      in medication use compared to the NSC group (P < .001). The RYGB group ceased the 
      use of antihypertensive and antihyperlipidemia medications by 1 year despite 
      abnormal values. CONCLUSION: RYGB can be performed in patients with both a BMI 
      <35 kg/m(2) and T2DM with better weight loss, glycemic control, and fewer 
      antihyperglycemic medications than NSC. Inappropriate cessation of medications 
      may partially explain the persistent increase in both SBP and LDL after RYGB.
CI  - Copyright (c) 2011 Mosby, Inc. All rights reserved.
FAU - Serrot, Federico J
AU  - Serrot FJ
AD  - Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
FAU - Dorman, Robert B
AU  - Dorman RB
FAU - Miller, Christopher J
AU  - Miller CJ
FAU - Slusarek, Bridget
AU  - Slusarek B
FAU - Sampson, Barbara
AU  - Sampson B
FAU - Sick, Brian T
AU  - Sick BT
FAU - Leslie, Daniel B
AU  - Leslie DB
FAU - Buchwald, Henry
AU  - Buchwald H
FAU - Ikramuddin, Sayeed
AU  - Ikramuddin S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Blood Glucose)
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Hypolipidemic Agents)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Aged
MH  - Antihypertensive Agents/therapeutic use
MH  - Blood Glucose/metabolism
MH  - Blood Pressure
MH  - Body Mass Index
MH  - Cholesterol, LDL/blood
MH  - Diabetes Complications/pathology/physiopathology/*surgery/therapy
MH  - Diabetes Mellitus, Type 2/*complications/drug therapy/*pathology/physiopathology
MH  - Female
MH  - *Gastric Bypass/adverse effects
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Hypolipidemic Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications/pathology/*surgery/therapy
MH  - Retrospective Studies
MH  - Weight Loss
EDAT- 2011/10/18 06:00
MHDA- 2011/12/13 00:00
CRDT- 2011/10/18 06:00
PHST- 2011/03/02 00:00 [received]
PHST- 2011/07/22 00:00 [accepted]
PHST- 2011/10/18 06:00 [entrez]
PHST- 2011/10/18 06:00 [pubmed]
PHST- 2011/12/13 00:00 [medline]
AID - S0039-6060(11)00425-9 [pii]
AID - 10.1016/j.surg.2011.07.069 [doi]
PST - ppublish
SO  - Surgery. 2011 Oct;150(4):684-91. doi: 10.1016/j.surg.2011.07.069.