Surgical Treatment Better Than Medical Therapy in Severely Obese Adolescents With T2D

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In Teen-LABS there was a 29% decrease in body mass index compared with baseline, while a 3.7% increase was seen in TODAY.
In Teen-LABS there was a 29% decrease in body mass index compared with baseline, while a 3.7% increase was seen in TODAY.

HealthDay News — Surgical treatment of severe obesity in adolescents with type 2 diabetes is associated with better glycemic control and weight reduction than medical therapy, according to a study published online in JAMA Pediatrics.

Thomas H. Inge, MD, PhD, from the University of Colorado Denver in Aurora, and colleagues compared glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions.

Data were obtained for participants in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS), who underwent a primary bariatric surgical procedure, and the Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY) consortia, who were randomized to metformin alone or in combination with rosiglitazone or an intensive lifestyle intervention. Data from 30 Teen-LABS participants and 63 TODAY participants were analyzed.

The researchers found that the mean hemoglobin A1c concentration decreased from 6.8% to 5.5% in Teen-LABS and increased from 6.4% to 7.8% in TODAY participants during 2 years. In Teen-LABS there was a 29% decrease in body mass index compared with baseline, while a 3.7% increase was seen in TODAY. During 2-year follow-up, 23% of Teen-LABS participants required a subsequent operation.

"These data support the need for a well-designed, prospective controlled study to define the role of surgery for adolescents with type 2 diabetes, including health and surgical outcomes," the authors write.

Several authors disclosed financial ties to the pharmaceutical and weight loss industries.

Reference

Inge TH, Laffel LM, Jenkins TM, et al. Comparison of surgical and medical therapy for type 2 diabetes in severely obese adolescents [published online March 12, 2018]. JAMA Pediatr. doi: 10.1001/jamapediatrics.2017.5763

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