Philip R Schauer of the Cleveland Clinic reported at the ACC 2012 meeting on the latest results of the STEMPEDE trial, which showed that bariatric surgery achieved better glycemic control and better biochemical parameters than drug therapy alone. 7.0% and BMI 27-43 kg/m2. were randomly assigned to IMT, IMT + Roux-en-Y gastric bypass (Bypass), and IMT + sleeve gastrectomy (Sleeve) with 12 months of follow-up. The primary endpoint was the success rate of achieving HbA1c ≤6.0%, and the secondary endpoints were changes in fasting glucose, BMI, lipids, blood pressure, hs-CRP, changes in medications, and safety. 12.2% of patients in the IMT group achieved HbA1c ≤6.0%, 42% in the Bypass group, and 36.7% in the Sleeve group (P values compared with IMT were 0.002 and 0.008); 42% of the Bypass patients and 26.5% of the Sleeve patients even achieved HbA1c ≤6.0% without taking glucose-lowering drugs. The reductions in fasting glucose were -28 mg/dL, -87 mg/dL, and -63 mg/dL in the IMT, Bypass, and Sleeve groups, respectively (P values of 0.004 and 0.003 compared with IMT). reductions in BMI were -1.9, -10.2, and -9.0 in the IMT, Bypass, and Sleeve groups, respectively (P values of <0.001 compared with IMT). P values were <0.001). Elevated HDL-C was significantly better in both surgical groups than in the IMT group, and triglycerides were significantly lower in the Bypass group than in the IMT group. The reduction of hs-CRP was significantly greater in the two surgical groups than in the IMT group. The surgery two groups reduced the number of types of diabetes medications taken postoperatively, which was significantly different from the IMT group; the use of cardiovascular medications was also significantly reduced in the surgery two groups compared to IMT. The researchers concluded that weight loss surgery achieved better glycemic control and better biochemical parameters than drug therapy alone, and that surgery had moderate adverse effects. Weight loss surgery may be considered a treatment option for obese patients with type 2 diabetes who have poor glycemic control.