title: Clinical efficacy of bariatric surgery versus liraglutide in patients with type 2 diabetes and severe obesity: a 12-month retrospective evaluation.
abstract: OBJECTIVE
  To evaluate the clinical efficacy of bariatric surgery vs medical therapy with liraglutide on weight loss, glycemic control and cardiovascular risk profile in patients with type 2 diabetes and severe obesity.
  
  
  METHODS
  A retrospective evaluation was conducted in 31 patients with type 2 diabetes and severe obesity who had undergone bariatric surgery and in 31 patients with type 2 diabetes and comparable body weight who had added liraglutide to their background medical treatment in the period 2009-2013. Anthropometric parameters, glycemic control, treatment of diabetes and other comorbidities, safety and side effects before and 12 months after treatment were assessed.
  
  
  RESULTS
  Age was 47 ± 8 years (mean ± SD) in bariatric surgery and 56 ± 9 years in medical treatment group (p < 0.001); body mass index before treatment was 44 ± 7 and 40 ± 4 kg/m(2) in bariatric surgery and medical treatment, respectively (p = 0.03). Twelve months after treatment, average weight loss was 38 ± 15 kg among bariatric surgery patients, and 5 ± 8 kg in medical treatment group (p < 0.001). Glycemic control improved in both groups with greater improvement in bariatric surgery patients. The UKPDS risk score decreased in both groups, although it remained higher in medical treatment than in bariatric surgery patients (p < 0.001). Of note, almost 60 % of patients on liraglutide met the target of glycated hemoglobin <7 % (53 mmol/mol) and lost ≥5 % of body weight.
  
  
  CONCLUSIONS
  In severely obese type 2 diabetic patients, bariatric surgery reduced body weight and improved overall metabolic control to a greater extent than medical treatment. Randomized clinical studies are necessary.
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University of Naples, Via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cotugno
authors.forename: G
authors.initials: G
authors.lastname: Nosso
authors.forename: G
authors.initials: G
authors.lastname: Saldalamacchia
authors.forename: G
authors.initials: G
authors.lastname: Vitagliano
authors.forename: E
authors.initials: E
authors.lastname: Griffo
authors.forename: R
authors.initials: R
authors.lastname: Lupoli
authors.forename: L
authors.initials: L
authors.lastname: Angrisani
authors.forename: G
authors.initials: G
authors.lastname: Riccardi
authors.forename: B
authors.initials: B
authors.lastname: Capaldo
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000069450:Liraglutide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069450:Liraglutide