|Title:||Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: A randomized controlled trial||Authors:||LEE-MING CHUANG
|Issue Date:||2011||Journal Volume:||146||Journal Issue:||2||Start page/Pages:||143-148||Source:||Archives of Surgery||Abstract:||
Objectives: To determine the efficacies of 2 weight-reducing operations on diabetic control and the role of duodenum exclusion. Design: Double-blind randomized controlled trial. Setting: Department of Surgery of the Min-Sheng General Hospital, National Taiwan University. Patients:Westudied 60 moderately obese patients (body mass index >25 and <35) aged >30 to <60 years who had poorly controlled type 2 diabetes mellitus (T2DM) (hemoglobin A 1c [HbA1c]>7.5%) after conventional treatment (>6 months) from September 1, 2007, through June 30, 2008. Patients and observers were masked during the follow-up, which ended in 2009, 1 year after final enrollment. Interventions: Gastric bypass with duodenum exclusion (n=30) vs sleeve gastrectomy without duodenum exclusion (n=30). Main Outcome Measures: The primary outcome was remission of T2DM (fasting glucose <126 mg/dL and HbA1c<6.5% without glycemic therapy). Secondary measures included weight and metabolic syndrome. Analysis was by intention to treat. Results: Of the 60 patients enrolled, all completed the 12-month follow-up. Remission of T2DM was achieved by 28 (93%) in the gastric bypass group and 14 (47%) in the sleeve gastrectomy group (P=.02). Participants assigned to gastric bypass had lost more weight, achieved a lower waist circumference, and had lower glucose, HbA1c, and blood lipid levels than the sleeve gastrectomy group. No serious complications occurred in either group. Conclusions: Participants randomized to gastric bypass were more likely to achieve remission of T2DM. Duodenum exclusion plays a role in T2DM treatment and should be assessed. Trial Registration: clinicaltrials.gov Identifier: NCT00540462 (http://www. clinicaltrials.gov). ?2011 American Medical Association. All rights reserved.
|DOI:||10.1001/archsurg.2010.326||metadata.dc.subject.other:||hemoglobin A1c; adult; article; body mass; double blind procedure; duodenum; female; follow up; gastrectomy; glucose blood level; human; intermethod comparison; lipid blood level; major clinical study; male; metabolic syndrome X; non insulin dependent diabetes mellitus; outcome assessment; postoperative complication; priority journal; randomized controlled trial; remission; sleeve gastrectomy; stomach bypass; surgical approach; surgical technique; waist circumference; Adult; Blood Glucose; Body Mass Index; Diabetes Mellitus, Type 2; Double-Blind Method; Follow-Up Studies; Gastrectomy; Gastric Bypass; Hemoglobin A, Glycosylated; Humans; Middle Aged; Retrospective Studies; Treatment Outcome
|Appears in Collections:||醫學系|
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