PMID- 35513159
OWN - NLM
STAT- MEDLINE
DCOM- 20220621
LR  - 20221207
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 188
DP  - 2022 Jun
TI  - Roux-en-Y gastric bypass versus best medical treatment for type 2 diabetes 
      mellitus in adults with body mass index between 27 and 32 kg/m(2): A 5-year 
      randomized controlled trial.
PG  - 109900
LID - S0168-8227(22)00714-8 [pii]
LID - 10.1016/j.diabres.2022.109900 [doi]
AB  - AIMS: To evaluate the effects of Roux-en-Y gastric bypass (RYGB) versus best 
      medical treatment in Asians with type 2 diabetes mellitus (T2DM) and class I 
      obesity. METHODS: In this 5-year single-centre, open-label randomized controlled 
      trial, participants were randomized to RYGB or medical treatment including newer 
      classes of diabetes medications (ClinicalTrials.gov:NCT02041234). The primary 
      endpoint was diabetes remission defined as HbA1c </= 6% (</=42 mmol/mol) and 
      discontinuation of glucose-lowering medication at 12 months post-intervention and 
      beyond. Glycaemia and weight changes were assessed. Continuous glucose monitoring 
      was performed. RESULTS: Of 28 subjects randomized, 26 were analyzed in the final 
      cohort (14 medical, 12 RYGB; age:44 +/- 10 years, 34.6% males, 
      BMI:29.4 +/- 1.6 kg/m(2)). At 12 months, 50% of RYGB subjects achieved diabetes 
      remission; 83% stopped all glucose-lowering medications. By year 5, 42% were in 
      remission. None attained diabetes remission in the medical group. Percentage 
      declines in fasting plasma glucose, HbA1c and BMI were significantly greater in 
      the RYGB arm (all P < 0.05). Early improvements in glycaemic variability and time 
      in range were similar in both treatment arms. Hypoglycaemia and surgical 
      complications were observed in some RYGB subjects. CONCLUSIONS: Over 5 years, 
      RYGB outperforms best medical treatment in glycemia and weight improvements for 
      Asians with T2DM and class I obesity.
CI  - Copyright (c) 2022 Elsevier B.V. All rights reserved.
FAU - Cheng, Anton
AU  - Cheng A
AD  - Department of General Surgery, Khoo Teck Puat Hospital, Singapore; Clinical 
      Research Unit, Khoo Teck Puat Hospital, Singapore. Electronic address: 
      cheng.anton.ks@ktph.com.sg.
FAU - Yeoh, Ester
AU  - Yeoh E
AD  - Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore.
FAU - Moh, Angela
AU  - Moh A
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
FAU - Low, Serena
AU  - Low S
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, 
      Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore.
FAU - Tan, Chun Hai
AU  - Tan CH
AD  - Department of General Surgery, Khoo Teck Puat Hospital, Singapore; Integrated 
      Centre for Obesity and Diabetes, Khoo Teck Puat Hospital, Singapore.
FAU - Lam, Benjamin
AU  - Lam B
AD  - Integrated Centre for Obesity and Diabetes, Khoo Teck Puat Hospital, Singapore.
FAU - Sum, Chee Fang
AU  - Sum CF
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, 
      Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore.
FAU - Subramaniam, Tavintharan
AU  - Subramaniam T
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, 
      Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore.
FAU - Lim, Su Chi
AU  - Lim SC
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, 
      Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore; Saw Swee Hock 
      School of Public Health, National University Hospital, Singapore; Lee Kong Chian 
      School of Medicine, Nanyang Technological University, Singapore.
LA  - eng
SI  - ClinicalTrials.gov/NCT02041234
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20220502
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - Blood Glucose Self-Monitoring
MH  - Body Mass Index
MH  - *Diabetes Mellitus, Type 2/drug therapy/surgery
MH  - Female
MH  - *Gastric Bypass
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity/complications
MH  - *Obesity, Morbid/complications
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Class I obesity
OT  - Continuous glucose monitoring
OT  - Glucagon-like peptide 1 receptor agonist
OT  - Roux-en-Y gastric bypass
OT  - Sodium-glucose cotransporter 2 inhibitor
OT  - Type 2 diabetes mellitus
EDAT- 2022/05/06 06:00
MHDA- 2022/06/22 06:00
CRDT- 2022/05/05 21:46
PHST- 2021/09/02 00:00 [received]
PHST- 2022/04/24 00:00 [revised]
PHST- 2022/04/27 00:00 [accepted]
PHST- 2022/05/06 06:00 [pubmed]
PHST- 2022/06/22 06:00 [medline]
PHST- 2022/05/05 21:46 [entrez]
AID - S0168-8227(22)00714-8 [pii]
AID - 10.1016/j.diabres.2022.109900 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2022 Jun;188:109900. doi: 10.1016/j.diabres.2022.109900. 
      Epub 2022 May 2.