Preliminary Data from Joslin Study Shows Gastric Bypass More Effective Than Lifestyle Modification for People with Type 2 Diabetes
Findings may inform therapeutic decisions for weight loss strategies in obese patients with Type 2 diabetes
BOSTON – June 23, 2013 – In a paper presented today at the 73rd Scientific Sessions of the American Diabetes Association in Chicago, Joslin researchers report preliminary data suggesting Roux-en-Y gastric bypass surgery provides greater improvements in blood sugars and weight lost than intensive lifestyle modification at one year for people with type 2 diabetes.
Allison Goldfine, M.D.., is head of the Section on Clinical, Behavioral & Outcomes Research and an Associate Professor of Medicine at Harvard Medical School.
The data reported findings from the one-year outcomes of the SLIMM-T2D trial, in which overweight patients with type 2 diabetes are randomized to two separate types of intervention to achieve weight loss and diabetes management, either Roux-en-Y gastric bypass surgery or intensive lifestyle modification (Joslin’s Why WAIT program).
“The gastric bypass did better at one year,” said Allison Goldfine, M.D., “with reduced cardiovascular risk factors, improving their blood sugars, and reductions or eliminations of the medications they used for diabetes, blood pressure, and cholesterol management.”
Both groups had clinically important weight loss and improved glucose levels at 3 months, but patients who had undergone bypass surgery, however, showed greater improvements in weight loss, blood glucose levels, and cardiovascular risk facts than those in lifestyle modification at one year.
Aside from medical outcomes, patients from both intervention groups reported similar increased satisfaction with themselves and their health.
“On most of the scales that measure social and physical functioning, people felt as well after participation in the Why WAIT program as they did following the surgical intervention,” said Dr. Goldfine. “So it’s very interesting how much weight loss is enough to feel better and empowered, or what the knowledge and education from the Why WAIT imparts on a patient’s quality of life.”
The main objective of the SLIMM-T2D trial was to determine the feasibility of randomizing patients into either lifestyle medication or bariatric surgery. The hope is to use these methods in a larger, multi-site trial to further understand the effects of bariatric surgery versus lifestyle modification on type 2 diabetes treatment and management.
SLIMM-T2D will continue to follow participants for at least three years to assess how each method fares in the long-term, and enrollment in a study to compare the laparoscopic adjustable gastric band to Why WAIT is ongoing.