Bariatric Surgery for Weight Loss and Glycemic Control in Nonmorbidly Obese Adults With Diabetes

Maggard-Gibbons, Melinda; Maglione, Margaret; Livhits, Masha J.; Ewing, Brett; Maher, Alicia Ruelaz; Hu, Jianhui; Li, Zhaoping; Shekelle, Paul G

doi:10.1001/jama.2013.4851

Cited by 208 publications

(122 citation statements)

References 75 publications

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“…Higher remission rates with greater weight loss have also been reported. 74 Although we did not investigate weight loss as a predictor of diabetes remission due to limited follow-up, a higher baseline BMI category was positively associated with remission and greater baseline BMI is known to be associated with greater weight loss. 6 Our results offer some suggestion that the effect of bariatric surgery may decline over time.…”

Section: Summary Of Findingsmentioning

confidence: 91%

“…42,74,142 Fewer data have been reported for SG and data with long follow-up are not available. A randomised trial of 60 participants suggested that GBP might be more effective than SG.…”

Section: Summary Of Findingsmentioning

confidence: 99%

“…73 Three reviews focused on the potential of bariatric surgery to treat T2DM in patients who were not morbidly obese (BMI < 40 kg/m 2 ). [74][75][76] The two older reviews identified one RCT of 60 patients with a BMI of 30-40 kg/m 2 who underwent adjustable gastric banding that reported on remission. 165 After 2 years, 73% of the surgery group and 13% of the controls were in remission from T2DM (p < 0.001).…”

Section: Type 2 Diabetes Remissionmentioning

confidence: 99%

“…The potential role of bariatric surgery in the treatment of diabetes in individuals with severe obesity is increasingly recognised. 35,74,140 A systematic review found that use of bariatric surgery in obese patients with T2DM was associated with remission of diabetes in approximately 70% of patients over the first 2 years following surgery. 74 However, most randomised trials have evaluated outcomes for small samples of patients, with outcomes reported more than 2 years following surgery only for a few patients.…”

Section: Introductionmentioning

confidence: 99%

“…35,74,140 A systematic review found that use of bariatric surgery in obese patients with T2DM was associated with remission of diabetes in approximately 70% of patients over the first 2 years following surgery. 74 However, most randomised trials have evaluated outcomes for small samples of patients, with outcomes reported more than 2 years following surgery only for a few patients. 6 There are similarly few non-randomised studies that have reported on outcomes of diabetic patients more than 2 years after bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

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Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

Gulliford

Charlton

Booth

et al. 2016

Health Serv Deliv Res

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et al. Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records. Health Serv Deliv Res 2016;4(17). Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/12. The contractual start date was in October 2013. The final report began editorial review in October 2015 and was accepted for publication in February 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinion...

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Section: Summary Of Findingsmentioning

confidence: 91%

“…42,74,142 Fewer data have been reported for SG and data with long follow-up are not available. A randomised trial of 60 participants suggested that GBP might be more effective than SG.…”

Section: Summary Of Findingsmentioning

confidence: 99%

Section: Type 2 Diabetes Remissionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

Gulliford

Charlton

Booth

et al. 2016

Health Serv Deliv Res

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New Obesity Guidelines

Jensen

Ryan

2014

JAMA

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Obesity is a major contributor to many chronic diseases and, because more than 1 in 3 US adults are obese, 1 a public health challenge. The goal of new obesity guidelines is to help primary care clinicians manage obesity more effectively. Obesity 2 (published as "2013 ACCF/ AHA/TOS Guidelines for the Management of Overweight and Obesity in Adults" 2 ) has been long awaited. The expert panel for Obesity 2 was first convened in September 2008 by the National Heart, Lung, and Blood Institute (NHLBI) and tasked with updating Obesity 1 (published in 1998 as "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults-The Evidence Report" 3 ). In 2013, the NHLBI elected to partner with the American Heart Association and the American College of Cardiology to promote and publish the guidelines. 4 The approach to guideline development followed the Institute of Medicine reports "Clinical Practice Guidelines We Can Trust" 5 and "Finding What Works in Health Care-Standards for Systematic Reviews." 6 The aim of this stringent methodology was to limit bias and produce trustworthy recommendations. Because of time and cost, the use of this stringent methodology limited both the scope of literature review under consideration (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) and the number of critical questions.From 23 critical questions suggested, the chosen 5 dealt with risks of overweight and obesity and the benefits of weight loss and evaluated 3 treatment areasdiet, behavioral therapies, and surgery. Questions 1 and 2 were chosen to help clinicians determine the appropriate criteria to guide a weight loss recommendation. Question 1 addressed the degree to which weight loss produces health benefits. Question 2 addressed the health risks of overweight and obesity and sought to determine if the current waist circumference and body mass index (BMI) cutpoints defining persons as overweight (BMI 25-29.9) and obese (BMI Ն30) are appropriate. Question 3 asked which dietary strategies are acceptable for weight loss efforts. Question 4 sought to determine the efficacy of a comprehensive lifestyle intervention approach (diet, physical activity, and behavior therapy) to achieve weight loss and weight loss maintenance. Question 5 addressed the efficacy and safety of various bariatric surgical procedures, including benefits and risks. To conserve resources for questions 3 through 5, questions 1 and 2 used primarily metaanalyses and systematic reviews.Because the questions were limited in number and scope, the recommendations are supplemented with an algorithm ("Chronic Disease Management Model for Primary Care of Patients With Overweight and Obesity") that incorporates recommendations and expert opinion to provide a roadmap for primary care clinicians.

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