[Skip to Content]
[Skip to Content Landing]
Views 351
Citations 0
Invited Commentary
June 3, 2020

Gastric Bypass vs Medical Treatment in Renoprotection for Patients with Class 1 Obesity, Type 2 Diabetes, and Albuminuria

Author Affiliations
  • 1Turku University, Department of Surgery, Turku, Finland
  • 2Turku University Hospital, Division of Digestive Surgery and Urology, Turku, Finland
  • 3Satasairaala Central Hospital, Department of Surgery, Pori, Finland
  • 4Turku University, Department of Internal Medicine, Turku, Finland
  • 5Turku Pet Center, Turku, Finland
  • 6Turku University, Department of Endocrinology, Turku, Finland
JAMA Surg. Published online June 3, 2020. doi:10.1001/jamasurg.2020.0421

The superiority of bariatric surgery over best medical therapy (BMT) in the treatment of type 2 diabetes has been well demonstrated in high-quality randomized clinical trials. Furthermore, there is sufficient clinical and mechanistic evidence to support consideration of metabolic surgery for the patients with class 1 obesity (body mass index [BMI], 30.0-34.9; calculated as weight in kilograms divided by height in meters squared), type 2 diabetes, and inadequately controlled hyperglycemia.1 At 5-year follow-up, compared with BMT, the Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) trial2 showed the durable and beneficial effects of bariatric surgery among patients with mild obesity (BMI of 27-34) and Diabetes Surgery Study3 found significant and superior improvement after bariatric surgery in a composite outcome of glycosylated hemoglobin level, low-density lipoprotein level, and systolic blood pressure.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words