Overview

• Following 3,932 adults with obesity and type 2 diabetes for up to a decade, the M6 study found superior long-term outcomes for those who had bariatric procedures versus GLP-1 therapy.
• Metabolic surgery was associated with a 32% lower risk of death, plus reductions in major cardiovascular events (35%), serious kidney disease (47%), and diabetic retinopathy (54%).
• Average weight loss over 10 years was 21.6% after surgery compared with 6.8% with GLP-1 medicines, and hemoglobin A1c improvement was greater with surgery (-0.86% versus -0.23%).
• Surgery patients required fewer prescriptions for diabetes, blood pressure, and cholesterol, and the study was published in Nature Medicine.
• The analysis was observational and included earlier as well as newer GLP-1 drugs, and investigators highlighted frequent medication discontinuation and the need for head-to-head trials with semaglutide and tirzepatide.