1226-P: Three Year Outcomes after Metabolic Surgery or Medical/Lifestyle Intervention: The ARMMS-T2D Trial

There is limited Level-1 evidence from well-powered randomized controlled trials (RCTs) examining improved glycemic control after metabolic surgery in patients with type 2 diabetes (T2D) and obesity. ARMMS-T2D is a multi-center consortium conducting a follow-up study of 4 merged RCTs in 256 patients with baseline Class 1-3 obesity and T2D, randomly assigned to metabolic surgery (MS; Roux-en-Y gastric bypass, sleeve gastrectomy, or gastric banding) or intensive Medical/Lifestyle Intervention (MLI). Three years after randomization, T2D remission rates were higher after MS than MLI (37.5%, 60/160 vs. 2.6%, 2/76, respectively, P In summary, this 3-year follow-up of the largest cohort of patients randomized to metabolic surgery vs. non-surgical treatment demonstrates that surgery is more effective than intensive medical/lifestyle therapy in achieving extended diabetes remission, BMI reduction, and improved metabolic disease biomarkers while reducing medication requirements. Disclosure J. P. Kirwan: None. J. M. Jakicic: Advisory Panel; Self; Naturally Slim, Spark360, Weight Watchers International, Inc. M. Patti: Consultant; Self; Cello Health, Fractyl Laboratories, Inc., MBX, Poxel SA, WGBH, Other Relationship; Self; Xeris Pharmaceuticals, Inc., Research Support; Self; Dexcom, Inc. K. Wolski: None. P. Schauer: Advisory Panel; Self; GI Dynamics, Keyron, Mediflix, Persona, Consultant; Self; Ethicon, Inc., Medtronic, Research Support; Self; Ethicon, Inc., Medtronic, Pacira. A. Courcoulas: None. D. E. Cummings: Advisory Panel; Self; DyaMx, GI Dynamics. A. Goldfine: Employee; Self; Novartis AG. S. Kashyap: Advisory Panel; Self; Fractyl Laboratories, Inc., GI Dynamics. D. C. Simonson: Stock/Shareholder; Spouse/Partner; Phase V Technologies, Inc. D. Arterburn: None. W. F. Gourash: None. A. H. Vernon: None. Funding National Institutes of Health (DK114156); Ethicon Endo-Surgery; Covidien