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Invited Commentary
October 2015

Bariatric Surgery vs Lifestyle Intervention for Type 2 Diabetes Mellitus

Author Affiliations
  • 1Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
  • 2Hopital du Sacre Coeur, Montreal, Quebec, Canada
JAMA Surg. 2015;150(10):940. doi:10.1001/jamasurg.2015.1542

I read with interest the article by Courcoulas et al1 in which outcomes were assessed 3 years after treating obese patients with type 2 diabetes mellitus (T2DM) who were randomized to an intensive lifestyle weight loss intervention for 1 year followed by a lower-level lifestyle weight loss intervention for 2 years or Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding followed by low-level lifestyle weight loss intervention. Partial or complete T2DM remission was achieved by 40% of Roux-en-Y gastric bypass, 29% of laparoscopic adjustable gastric banding, and no lifestyle weight loss intervention patients (P = .004). The use of medications was reduced more by surgery than lifestyle alone (P < .001).1 Mean reductions in percentage of body weight were the greatest after Roux-en-Y gastric bypass at 25.0%, laparoscopic adjustable gastric banding at 15.0%, and lifestyle treatment at 5.7% (P < .01).1 It was concluded that among obese participants with T2DM, surgery resulted in more remission than lifestyle intervention alone.