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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ELaparoscopic gastric banding and an intensive nonsurgical intervention appear to provide similar outcomes among patients who are obese with type 2 diabetes mellitus. At 1 year, patients who underwent gastric banding lost more weight than those who had no surgery, but no significant differences were seen in HbA\u003Csub\u003E1c\u003C\/sub\u003E, fasting blood sugar, or other cardiometabolic measures.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Egastric banding\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elifestyle intervention\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHbA\u003Csub\u003E1c\u003C\/sub\u003E\n            \u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eobesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Etype 2 diabetes mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENCT01073020\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eendocrinology, diabetes \u0026amp; metabolism clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiometabolic disorder\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EBecause of advances in both the surgical and nonsurgical treatment of obesity in adults with type 2 diabetes mellitus (T2DM), there is increasing controversy regarding the best treatment algorithm for patients who are obese with T2DM.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EThe SLIMM-T2D study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01073020\u0026amp;atom=%2Fspmdc%2F15%2F4%2F17.atom\u0022\u003ENCT01073020\u003C\/a\u003E] was a 1-year pragmatic randomized trial within a single hospital setting. The trial was designed to compare clinical outcomes between patients who are obese with T2DM who underwent laparoscopic adjustable gastric band surgery (LAGB) or Roux-en-Y gastric bypass (RYGB) and those who participated in Why WAIT, a nonsurgical intensive diabetes and weight loss intervention. Why WAIT incorporated intensive diet, exercise, education, and drug modification using a multidisciplinary approach that included a dietitian, a psychologist, a diabetes educator, an exercise physiologist, and a physician who prescribed medications considered weight neutral. Patients in the Why WAIT intervention received 2 hours of instruction per week and individualized exercise training for the first 12 weeks, with monthly one-on-one support visits for the remainder of the 1-year follow-up.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EThe primary end point was the number of patients with fasting blood sugar\u2005\u0026lt;\u2005126 mg\/dL and HbA\u003Csub\u003E1c\u003C\/sub\u003E \u0026lt;\u20056.5% at 1 year. Secondary end points included measurement of metabolic and cardiovascular risk factors.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EData from the RYGB arm of the trial were previously published [Halperin F et al. \u003Cem\u003EJAMA Surg\u003C\/em\u003E. 2014] and showed that, compared with medical management, RYGB produced sustained and statistically significant improvements in HbA\u003Csub\u003E1c\u003C\/sub\u003E and fasting glucose (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.03), as well as greater weight loss and reduction in cardiometabolic risk factors at 1 year.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EDonald C. Simonson, MD, MPH, ScD, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA, presented data from the LAGB arm of SLIMM-T2D. Forty patients were randomized to either LAGB (n\u2005=\u200518; 9 men, 9 women) or medical management (n\u2005=\u200522; 13 men, 9 women), with 12 months of follow-up. Other baseline characteristics are outlined in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16523\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16523\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16523\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EBaseline Patient Characteristics\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EAt 12 months, there was no significant difference between the 2 groups in the primary end point of HbA\u003Csub\u003E1c\u003C\/sub\u003E\u2005\u0026lt;\u20056.5% and fasting blood sugar\u2005\u0026lt;\u2005126 mg\/dL (\u003Cem\u003EP\u2005\u003C\/em\u003E=\u2005.46). There was also no significant difference in the number of patients who met all 3 treatment goals prescribed by the American Diabetes Association (HbA\u003Csub\u003E1c\u003C\/sub\u003E\u2005\u0026lt;\u20057.0%, low-density lipoprotein\u2005\u0026lt;\u2005100 mg\/dL, systolic blood pressure\u2005\u0026lt;\u2005130 mm Hg; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.77). However, patients in the LAGB group lost significantly more weight than their Why WAIT counterparts (\u201313.5\u2005\u00b1\u20051.7 kg vs \u22128.5\u2005\u00b1\u20051.6 kg; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u20050.05).\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EIn conclusion, among patients who are obese with T2DM, weight loss was significantly greater in the LAGB group. There were no significant differences in biochemical measures associated with either LAGB or an intensive weight and exercise management program. Programs similar to Why WAIT may be a plausible option for patients who are not good candidates for LAGB or who choose not to undergo the procedure.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/4\/17.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlmuq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlmuq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}