Would the initially observed benefits of surgery stand the test of time?

According to findings from a three-year follow-up study to STAMPEDE, also recently published in NEJM, the answer is yes.
The STAMPEDE trial investigators analyzed glycated hemoglobin levels to see how well glycemic control was maintained after three years.
This new analysis, based on 137 of the 150 original patients, found that those who underwent surgery still had better outcomes after three years than those who were assigned to medical therapy. In
absolute terms, the glycated hemoglobin levels among surgical patients decreased by an impressive 2.5 percentage points, versus only 0.6 percentage points for medical therapy patients (P<0.001).
More than a third of gastric bypass patients and roughly a quarter of sleeve gastrectomy patients achieved the target glycated hemoglobin level of 6% at three years (P<0.001 and P=0.01); in contrast,
only 5% of medical therapy patients reached this goal. Surgical patients also needed fewer diabetes medications. Remarkably, under 10% of surgical patients were using insulin at three years, versus
55% of patients from the medical therapy arm (P<0.001).
- See more at: http://blogs.nejm.org/now/index.php/after-the-stampede-surgical-versus-medical-treatment-for-obese-patients-with-diabetes/2014/05/21/#sthash.NjxJPxDo.dpuf