Changes in glycated hemoglobin levels Observational studies show bariatric surgery is effective in the treatment of type 2 diabetes. A more in-depth study was conducted by Philip R. Schaue, MD, PhD, and others at Harvard Medical School, and the results were published in the March 26, 2012 online edition of the leading international journal NEJM. This randomized, non-blinded, single-center study evaluated 150 patients with uncontrolled type 2 diabetes mellitus who were treated with intensive pharmacotherapy vs. medical therapy combined with Roux-en-Y gastric bypass or gastric sleeve resection. The mean (±SD) age of the subjects was 49±8 years, and 66% of the subjects were female. The mean glycosylated hemoglobin value was 9.2±1.5%. The main end-of-trial indicator was the proportion of patients who maintained a glycosylated hemoglobin level of 6.0% at 12 months after treatment. The results showed that 93% of the 150 patients completed the 12-month follow-up, with 10% (5 of 41) of patients in the medical therapy group achieving the trial primary endpoint, compared with 42% (21 of 50) in the gastric bypass group and 37% (18 of 49) in the sleeve gastrectomy group (P=0.008). Glycemic control improved in all three treatment groups, with mean glycosylated hemoglobin levels of 7.5±1.8% in the medicine treatment group, 6.4±0.9% in the gastric bypass treatment group (P<0.001), and 6.6±1.0% in the sleeve gastrectomy treatment group (P=0.003). In terms of weight loss, the gastric bypass treatment group and the sleeve gastrectomy treatment group showed better results with a mean loss of 29.4±9.0 kg and 25.1±8.5 kg, respectively, compared with a mean loss of 5.4±8.0 kg in the medicine treatment group (P<0.001 for both groups). Patients in both surgical treatment groups received significant results after taking hypoglycemic, lipid-lowering and blood pressure-lowering drugs, while the effect was not significant in the single pharmaceutical treatment group. The HOMA-IR indexes of the patients were significantly improved after the bariatric surgery. In terms of adverse effects, four patients required reoperation and no patients died or had life-threatening complications. CONCLUSION: In patients with uncontrolled type 2 diabetes mellitus, 12 months of medical therapy combined with bariatric surgery treatment showed superior glycemic control effects than single medical therapy. Further studies are needed to confirm the sustainability assessment of the results.