This randomized, nonblinded, single-center trial evaluated the efficacy of intensive medical therapy alone versus medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy in 150 obese patients with uncontrolled type 2 diabetes. The primary endpoint was the proportion of patients with a glycated hemoglobin level of 6.0% or less 12 months after treatment. The results showed that 42% of patients in the gastric-bypass group and 37% in the sleeve-gastrectomy group achieved the primary endpoint, compared to only 12% in the medical-therapy group (P = 0.002 and P = 0.008, respectively). Glycemic control improved in all three groups, with significant reductions in glycated hemoglobin levels and fasting plasma glucose. Weight loss was greater in the gastric-bypass and sleeve-gastrectomy groups (−29.4 ± 9.0 kg and −25.1 ± 8.5 kg, respectively) compared to the medical-therapy group (−5.4 ± 8.0 kg). The use of glucose, lipid, and blood-pressure medications decreased significantly after both surgical procedures but increased in patients receiving medical therapy only. The study concluded that in obese patients with uncontrolled type 2 diabetes, 12 months of medical therapy plus bariatric surgery achieved glycemic control in significantly more patients than medical therapy alone. Further studies are needed to assess the long-term durability of these results.This randomized, nonblinded, single-center trial evaluated the efficacy of intensive medical therapy alone versus medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy in 150 obese patients with uncontrolled type 2 diabetes. The primary endpoint was the proportion of patients with a glycated hemoglobin level of 6.0% or less 12 months after treatment. The results showed that 42% of patients in the gastric-bypass group and 37% in the sleeve-gastrectomy group achieved the primary endpoint, compared to only 12% in the medical-therapy group (P = 0.002 and P = 0.008, respectively). Glycemic control improved in all three groups, with significant reductions in glycated hemoglobin levels and fasting plasma glucose. Weight loss was greater in the gastric-bypass and sleeve-gastrectomy groups (−29.4 ± 9.0 kg and −25.1 ± 8.5 kg, respectively) compared to the medical-therapy group (−5.4 ± 8.0 kg). The use of glucose, lipid, and blood-pressure medications decreased significantly after both surgical procedures but increased in patients receiving medical therapy only. The study concluded that in obese patients with uncontrolled type 2 diabetes, 12 months of medical therapy plus bariatric surgery achieved glycemic control in significantly more patients than medical therapy alone. Further studies are needed to assess the long-term durability of these results.