Table 1.
Anthropometry, type 2 diabetes control, and albuminuria in metabolic surgery RCTs in patients with obesity and type 2 diabetes.
| Study | Study arms | Follow-up (months) | Body weight (kg) | BMI (kg/m2) | T2D duration (years) | HbA1c (%) | HbA1c ≤6.5% without diabetes medications [n (%)] | HbA1c ≤6% without diabetes medications [n (%)] | Albuminuriaa [n (%)] |
|---|---|---|---|---|---|---|---|---|---|
| Schauer et al. (STAMPEDE) (29, 49, 60) | |||||||||
| RYGB + IMT | 0 | 107 ± 15 | 37 ± 3 | 8 ± 6 | 9 ± 1 | – | – | 17 (34) | |
| 12 | 77 ± 13 | 27 ± 3 | – | 6 ± 1 | – | 21 (42) | – | ||
| 36 | 81 ± 16 | 28 | – | 7 ± 1 | 22 (46) | 17 (35) | – | ||
| 60 | 83 ± 15 | 29 | – | 7 ± 2 | 15 (31) | 11 (22) | 9 (19) | ||
| VSG + IMT | 0 | 101 ± 16 | 36 ± 4 | 9 ± 5 | 10 ± 2 | – | – | 12 (24) | |
| 12 | 76 ± 13 | 27 ± 4 | – | 7 ± 1 | – | 13 (27) | – | ||
| 36 | 79 ± 15 | 29 | – | 7 ± 1 | 14 (29) | 10 (20) | – | ||
| 60 | 82 ± 15 | 29 | – | 7 ± 2 | 11 (23) | 7 (15) | 5 (11) | ||
| IMT | 0 | 107 ± 15 | 37 ± 3 | 9 ± 6 | 9 ± 1 | – | – | 10 (20) | |
| 12 | 99 ± 16 | 34 ± 4 | – | 8 ± 2 | – | 0 (0) | – | ||
| 36 | 100 ± 17 | 35 | – | 8 ± 2 | 0 (0) | 0 (0) | – | ||
| 60 | 99 ± 17 | 34 | – | 9 ± 2 | 0 (0) | 0 (0) | 8 (22) | ||
| Ikramuddin et al. (DSS) (61–63) | |||||||||
| RYGB + IMT | 0 | 99 ± 14 | 35 (34-36) | 9 ± 6 | 10 ± 1 | – | – | – | |
| 12 | 73 ± 14 | 26 (25-27) | – | 6 ± 1 | 0 (0) | 0 (0) | – | ||
| 24 | – | 27 (26-27) | – | 7 ± 2 | 25 (42) | 15 (25) | – | ||
| 60 | – | 27 (27-28) | – | 7 (7-8) | 9 (16) | 4 (7) | – | ||
| IMT | 0 | 98 ± 17 | 34 (34-35) | 9 ± 6 | 10 ± 1 | – | – | – | |
| 12 | 90 ± 17 | 32 (31-32) | – | 8 ± 2 | 0 (0) | 0 (0) | – | ||
| 24 | – | 32 (31-33) | – | 8 ± 3 | 0 (0) | 0 (0) | – | ||
| 60 | – | 31 (30-32) | – | 9 (8-9) | 0 (0) | 0 (0) | – | ||
| Mingrone et al. (64, 65) | |||||||||
| RYGB + IMT | 0 | 130 ± 23 | 45 ± 5 | 6 ± 1 | 9 ± 1 | – | – | 3 (16) | |
| 24 | 84 ± 13 | 29 ± 3 | – | 6 ± 1 | 15 (75) | – | – | ||
| 60 | 90 ± 13 | 31 ± 3 | – | 7 ± 1 | 8 (42) | 1 (5) | 0 (0) | ||
| BPD/DS + IMT | 0 | 138 ± 30 | 45 ± 8 | 6 ± 1 | 9 ± 2 | – | – | 2 (11) | |
| 24 | 90 ± 18 | 29 ± 5 | – | 5 ± 0.5 | 19 (95) | – | – | ||
| 60 | 93 ± 14 | 30 ± 4 | – | 6 ± 0.4 | 13 (68) | 7 (37) | 0 (0) | ||
| IMT | 0 | 136 ± 22 | 46 ± 6 | 6 ± 1 | 9 ± 1 | – | – | 4 (27) | |
| 24 | 128 ± 20 | 43 ± 6 | – | 8 ± 1 | 0 (0) | 0 (0) | – | ||
| 60 | 127 ± 21 | 42 ± 6 | – | 7 ± 1 | 0 (0) | 0 (0) | 4 (27) | ||
| Cummings et al. (CROSSROADS) (66) | |||||||||
| RYGB + IMT | 0 | 109 ± 15 | 38 ± 4 | 11 ± 5 | 8 ± 1 | – | – | – | |
| 12 | – | – | – | 6 ± 2 | 9 (60) | 9 (60) | – | ||
| ILMI | 0 | 113 ± 17 | 37 ± 4 | 7 ± 5 | 7 ± 1 | – | – | – | |
| 12 | – | – | – | 7 ± 1 | 1 (6) | 1 (6) | – | ||
| Dixon et al. (67) | |||||||||
| AGB + IMT | 0 | 106 ± 14 | 37 ± 3 | – | 8 ± 1 | – | – | – | |
| 24 | 85 ± 16 | – | – | 6 ± 1 | – | 22 (73)b | – | ||
| IMT | 0 | 106 ± 14 | 37 ± 3 | – | 8 ± 1 | – | – | – | |
| 24 | 105 ± 15 | – | – | 7 ± 1 | 0 (0) | 4 (13)b | – | ||
Albuminuria, urine albumin/creatinine ratio ≥3 mg albumin per mmol of creatinine.
Type 2 diabetes remission defined as HbA1c <6.2% and fasting plasma glucose <126 mg/dL without hypoglycaemic medication usage in this study.
Mean ± SD or mean (95% CI) are presented for normally distributed continuous variables; n (%) are presented for categorical variables.
AGB, adjustable gastric banding; BMI, body-mass index; BPD/DS, biliopancreatic diversion/duodenal switch; DSS, Diabetes Surgery Study; HbA1c, glycated haemoglobin; ILMI, intensive lifestyle and medical intervention; IMT, intensive medical therapy; RYGB, Roux-en-Y gastric bypass; T2D, type 2 diabetes mellitus; VSG, vertical sleeve gastrectomy.