Evidence map›Paper›PMID 26132586›Full record

Trial reportJAMA surgery2015

Three-Year Outcomes of Bariatric Surgery vs Lifestyle Intervention for Type 2 Diabetes Mellitus Treatment: A Randomized Clinical Trial.

Anita P Courcoulas, Steven H Belle, Rebecca H Neiberg, Sheila K Pierson, Jessie K Eagleton, Melissa A Kalarchian, James P DeLany, Wei Lang, John M Jakicic

2 registry-linked trialsAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 184 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
184citing papers in PubMed, 21 pooled it
43.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01047735 naactive not recruitingnot on this map

Randomized Trial to Compare Surgical and Medical Treatments for Type 2 Diabetes (Triabetes) - Alliance of Randomized Trials of Medicine vs. Metabolic Surgery in Type 2 Diabetes ARMMST2D)

TypeinterventionalSponsorUniversity of PittsburghRan2009 to 2028Enrolled69ConditionsType 2 Diabetes Mellitus, ObesityArmsRoux-en-Y Gastric Bypass Surgery, Laparoscopic Adjustable Gastric Banding, Lifestyle Weight Loss Intervention
NCT07539766 recruitingnot on this mapstarted 2025, after this paper: background citation

OBESE-HFpEF: Prevalence and Mediators of Heart Failure (Preserved Ejection Fraction) in the Dutch Obesity Clinic South - Towards Preventing Obesity Related HFpEF''

Typeobservational_patient_registrySponsorZuyderland Medisch CentrumRan2025 to 2029Enrolled250ConditionsHeart Failure and Preserved Ejection Fraction, Obesity (Disorder), Heart Failure
3 · Its place in the literature

Who cites it

184 citing papers in PubMed, 21 syntheses or guidelines pooled it, 364 citations in OpenAlex.

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124 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Anita P CourcoulasDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Steven H BelleDepartment of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania3Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Rebecca H NeibergDepartment of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, South Carolina.
Sheila K PiersonDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Jessie K EagletonDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Melissa A KalarchianSchool of Nursing, Duquesne University, Pittsburgh, Pennsylvania.
James P DeLanyDivision of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Wei LangDepartment of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, South Carolina.
John M JakicicPhysical Activity and Weight Management Research Center, Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania.
University of Pittsburgh · USUniversity of Pittsburgh Medical Center · USWake Forest University · USDuquesne University · US

Funding

VARIABILITY, STABILITY & SMOOTHNESS OF WALKINGP30AG024827 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Caterina Rosano · 2004 to 2026
$28.6M
A Randomized Trial to Compare Surgical and Medical Treatments for Type 2 DiabetesR01DK095128 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI COURCOULAS, ANITA P · 2012 to 2014
$879k
NIA NIH HHS P30 AG024827NIDDK NIH HHS R01 DK095128NIDDK NIH HHS R01DK095128
6 · The paper itself

Abstract

importanceQuestions remain about the role and durability of bariatric surgery for type 2 diabetes mellitus (T2DM).

objectiveTo compare the remission of T2DM following surgical and nonsurgical treatments. DESIGN, SETTING, AND

participantsIn this 3-arm randomized clinical trial conducted at the University of Pittsburgh Medical Center from October 1, 2009, to June 26, 2014, in Pittsburgh, Pennsylvania, outcomes were assessed 3 years after treating 61 obese participants aged 25 to 55 years with T2DM. Analysis was conducted with an intent-to-treat population.

interventionsParticipants were randomized to either an intensive lifestyle weight loss intervention for 1 year followed by a low-level lifestyle intervention for 2 years or surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) followed by low-level lifestyle intervention in years 2 and 3. MAIN OUTCOMES AND MEASURES: Primary end points were partial and complete T2DM remission and secondary end points included diabetes medications and weight change.

resultsBody mass index (calculated as weight in kilograms divided by height in meters squared) was less than 35 for 26 participants (43%), 50 (82%) were women, and 13 (21%) were African American. Mean (SD) values were 100.5 (13.7) kg for weight, 47.3 (6.6) years for age, 7.8% (1.9%) for hemoglobin A1c level, and 171.3 (72.5) mg/dL for fasting plasma glucose level. Partial or complete T2DM remission was achieved by 40% (n = 8) of RYGB, 29% (n = 6) of LAGB, and no intensive lifestyle weight loss intervention participants (P = .004). The use of diabetes medications was reduced more in the surgical groups than the lifestyle intervention-alone group, with 65% of RYGB, 33% of LAGB, and none of the intensive lifestyle weight loss intervention participants going from using insulin or oral medication at baseline to no medication at year 3 (P < .001). Mean (SE) reductions in percentage of body weight at 3 years were the greatest after RYGB at 25.0% (2.0%), followed by LAGB at 15.0% (2.0%) and lifestyle treatment at 5.7% (2.4%) (P < .01). CONCLUSIONS AND RELEVANCE: Among obese participants with T2DM, bariatric surgery with 2 years of an adjunctive low-level lifestyle intervention resulted in more disease remission than did lifestyle intervention alone.

trial registrationclinicaltrials.gov Identifier: NCT01047735.

Indexed as

Gastric BypassLife StyleAdultDiabetes Mellitus, Type 2FemaleHumansMaleMiddle AgedObesityTime FactorsTreatment Outcome

Identifiers

PMID26132586
PMCPMC4905566
OpenAlexW2157418166

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.