{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:35:30Z","timestamp":1793370930621,"version":"4.5.0"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,2,27]]},"abstract":"\n Importance<\/jats:title>\n Randomized clinical trials of bariatric surgery have been limited in size, type of surgical procedure, and follow-up duration.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine long-term glycemic control and safety of bariatric surgery compared with medical\/lifestyle management of type 2 diabetes.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n ARMMS-T2D (Alliance of Randomized Trials of Medicine vs Metabolic Surgery in Type 2 Diabetes) is a pooled analysis from 4 US single-center randomized trials conducted between May 2007 and August 2013, with observational follow-up through July 2022.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Participants were originally randomized to undergo either medical\/lifestyle management or 1 of the following 3 bariatric surgical procedures: Roux-en-Y gastric bypass, sleeve gastrectomy, or adjustable gastric banding.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n \n The primary outcome was change in hemoglobin A\n 1c<\/jats:sub>\n (HbA\n 1c<\/jats:sub>\n ) from baseline to 7 years for all participants. Data are reported for up to 12 years.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 262 of 305 eligible participants (86%) enrolled in long-term follow-up for this pooled analysis. The mean (SD) age of participants was 49.9 (8.3) years, mean (SD) body mass index was 36.4 (3.5), 68.3% were women, 31% were Black, and 67.2% were White. During follow-up, 25% of participants randomized to undergo medical\/lifestyle management underwent bariatric surgery. The median follow-up was 11 years. At 7 years, HbA\n 1c<\/jats:sub>\n decreased by 0.2% (95% CI, \u22120.5% to 0.2%), from a baseline of 8.2%, in the medical\/lifestyle group and by 1.6% (95% CI, \u22121.8% to \u22121.3%), from a baseline of 8.7%, in the bariatric surgery group. The between-group difference was \u22121.4% (95% CI, \u22121.8% to \u22121.0%;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) at 7 years and \u22121.1% (95% CI, \u22121.7% to \u22120.5%;\n P<\/jats:italic>\n \u2009=\u2009.002) at 12 years. Fewer antidiabetes medications were used in the bariatric surgery group. Diabetes remission was greater after bariatric surgery (6.2% in the medical\/lifestyle group vs 18.2% in the bariatric surgery group;\n P<\/jats:italic>\n \u2009=\u2009.02) at 7 years and at 12 years (0.0% in the medical\/lifestyle group vs 12.7% in the bariatric surgery group;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). There were 4 deaths (2.2%), 2 in each group, and no differences in major cardiovascular adverse events. Anemia, fractures, and gastrointestinal adverse events were more common after bariatric surgery.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion and Relevance<\/jats:title>\n After 7 to 12 years of follow-up, individuals originally randomized to undergo bariatric surgery compared with medical\/lifestyle intervention had superior glycemic control with less diabetes medication use and higher rates of diabetes remission.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT02328599<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2024.0318","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T11:30:53Z","timestamp":1709033453000},"page":"654","source":"Crossref","is-referenced-by-count":284,"title":["Long-Term Outcomes of Medical Management vs Bariatric Surgery in Type 2 Diabetes"],"prefix":"10.1001","volume":"331","author":[{"given":"Anita 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