{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:46:00Z","timestamp":1790675160696,"version":"4.1.0"},"reference-count":26,"publisher":"American Diabetes Association","issue":"9","license":[{"start":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T00:00:00Z","timestamp":1471910400000},"content-version":"vor","delay-in-days":68,"URL":"http:\/\/diabetesjournals.org\/site\/license"}],"funder":[{"DOI":"10.13039\/501100002736","name":"Covidien","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002736","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30-DK-050456"],"award-info":[{"award-number":["P30-DK-050456"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000040"],"award-info":[{"award-number":["UL1 TR000040"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 RR024156"],"award-info":[{"award-number":["UL1 RR024156"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We compared 3-year achievement of an American Diabetes Association composite treatment goal (HbA1c &amp;lt;7.0%, LDL cholesterol &amp;lt;100 mg\/dL, and systolic blood pressure &amp;lt;130 mmHg) after 2 years of intensive lifestyle-medical management intervention, with and without Roux-en-Y gastric bypass, with one additional year of usual care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>A total of 120 adult participants, with BMI 30.0\u201339.9 kg\/m2 and HbA1c \u22658.0%, were randomized 1:1 to two treatment arms at three clinical sites in the U.S. and one in Taiwan. All patients received the lifestyle-medical management intervention for 24 months; half were randomized to also receive gastric bypass.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>At 36 months, the triple end point goal was met in 9% of lifestyle-medical management patients and 28% of gastric bypass patients (P = 0.01): 10% and 19% lower than at 12 months. Mean (SD) HbA1c values at 3 years were 8.6% (3.5) and 6.7% (2.0) (P &amp;lt; 0.001). No lifestyle-medical management patient had remission of diabetes at 36 months, whereas 17% of gastric bypass patients had full remission and 19% had partial remission. Lifestyle-medical management patients used more medications than gastric bypass patients: mean (SD) 3.8 (3.3) vs. 1.8 (2.4). Percent weight loss was mean (SD) 6.3% (16.1) in lifestyle-medical management vs. 21.0% (14.5) in gastric bypass (P &amp;lt; 0.001). Over 3 years, 24 serious or clinically significant adverse events were observed in lifestyle-medical management vs. 51 with gastric bypass.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Gastric bypass is more effective than lifestyle-medical management intervention in achieving diabetes treatment goals, mainly by improved glycemic control. However, the effect of surgery diminishes with time and is associated with more adverse events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc15-2481","type":"journal-article","created":{"date-parts":[[2016,6,17]],"date-time":"2016-06-17T03:19:43Z","timestamp":1466133583000},"page":"1510-1518","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":96,"title":["Durability of Addition of Roux-en-Y Gastric Bypass to Lifestyle Intervention and Medical Management in Achieving Primary Treatment Goals for Uncontrolled Type 2 Diabetes in Mild to Moderate Obesity: A Randomized Control Trial"],"prefix":"10.2337","volume":"39","author":[{"given":"Sayeed","family":"Ikramuddin","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Korner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Jei","family":"Lee","sequence":"additional","affiliation":[{"name":"Surgery Department, National Taiwan University Hospital, Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Bantle","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Diabetes, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avis J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Connett","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of Minnesota, 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MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keong","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Min-Sheng General Hospital, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee-Ming","family":"Chuang","sequence":"additional","affiliation":[{"name":"Division of Metabolism and Endocrinology, Internal Medicine Department, National Taiwan University Hospital, Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Vella","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Medicine, Mayo Clinic, Rochester, 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