Overview
- A secondary analysis published in Annals of Internal Medicine reports larger 7–12 year reductions in HbA1c and body weight after surgery than with medical and lifestyle therapy in adults with type 2 diabetes and obesity.
- Benefits were consistent across Area Deprivation Index strata, with no significant interaction by social vulnerability on glycemic or weight outcomes.
- The analysis evaluated 258 participants from four U.S. randomized trials that originally assigned 355 adults to medical management or to gastric bypass, sleeve gastrectomy, or adjustable gastric banding.
- Use of incretin-based drugs increased during follow-up, reaching roughly 37% in medical groups and 27% in surgical groups by year 12, which the authors note limits direct comparison with today’s newer agents.
- Researchers and outside experts describe surgery as underused and urge individualized decisions and long-term head-to-head data, as one report found GLP-1 prescriptions rose 132.6% between 2022 and 2023 while bariatric surgeries fell 25.6%.