The study compared bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) with intensive medical therapy in 150 obese patients with uncontrolled type 2 diabetes. The primary outcome was achieving a glycated hemoglobin (HbA1c) level of 6.0% or less at 12 months. The medical-therapy group had 12% of patients achieving this goal, while 42% in the gastric-bypass group and 37% in the sleeve-gastrectomy group did so. Glycemic control improved significantly in all groups, with the gastric-bypass group showing the greatest improvement. Weight loss was also greater in the surgical groups. The use of diabetes medications decreased significantly after surgery but increased in the medical-therapy group. The homeostasis model assessment of insulin resistance (HOMA-IR) improved after bariatric surgery. No deaths or life-threatening complications occurred. The study concluded that bariatric surgery combined with medical therapy achieved better glycemic control than medical therapy alone. The results suggest that bariatric surgery is a potentially effective treatment for type 2 diabetes in obese patients. However, further studies are needed to assess the long-term durability of these results. The study was funded by Ethicon Endo-Surgery and others. The growing prevalence of obesity and type 2 diabetes is a major public health challenge. Bariatric surgery has been shown to rapidly improve glycemic control and cardiovascular risk factors in severely obese patients with type 2 diabetes. However, few randomized trials have compared bariatric surgery with intensive medical therapy in moderately obese patients. The STAMPEDE trial aimed to address this gap by comparing the two approaches. The study was conducted at the Cleveland Clinic and involved 150 patients with a BMI of 27 to 43. Patients were randomized to receive intensive medical therapy alone or with bariatric surgery. The study found that bariatric surgery significantly improved glycemic control and weight loss compared to medical therapy alone. The results suggest that bariatric surgery is a promising treatment option for type 2 diabetes in obese patients. However, the long-term safety and efficacy of the procedure remain to be determined. The study highlights the importance of further research to evaluate the long-term benefits and risks of bariatric surgery in the treatment of type 2 diabetes.The study compared bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) with intensive medical therapy in 150 obese patients with uncontrolled type 2 diabetes. The primary outcome was achieving a glycated hemoglobin (HbA1c) level of 6.0% or less at 12 months. The medical-therapy group had 12% of patients achieving this goal, while 42% in the gastric-bypass group and 37% in the sleeve-gastrectomy group did so. Glycemic control improved significantly in all groups, with the gastric-bypass group showing the greatest improvement. Weight loss was also greater in the surgical groups. The use of diabetes medications decreased significantly after surgery but increased in the medical-therapy group. The homeostasis model assessment of insulin resistance (HOMA-IR) improved after bariatric surgery. No deaths or life-threatening complications occurred. The study concluded that bariatric surgery combined with medical therapy achieved better glycemic control than medical therapy alone. The results suggest that bariatric surgery is a potentially effective treatment for type 2 diabetes in obese patients. However, further studies are needed to assess the long-term durability of these results. The study was funded by Ethicon Endo-Surgery and others. The growing prevalence of obesity and type 2 diabetes is a major public health challenge. Bariatric surgery has been shown to rapidly improve glycemic control and cardiovascular risk factors in severely obese patients with type 2 diabetes. However, few randomized trials have compared bariatric surgery with intensive medical therapy in moderately obese patients. The STAMPEDE trial aimed to address this gap by comparing the two approaches. The study was conducted at the Cleveland Clinic and involved 150 patients with a BMI of 27 to 43. Patients were randomized to receive intensive medical therapy alone or with bariatric surgery. The study found that bariatric surgery significantly improved glycemic control and weight loss compared to medical therapy alone. The results suggest that bariatric surgery is a promising treatment option for type 2 diabetes in obese patients. However, the long-term safety and efficacy of the procedure remain to be determined. The study highlights the importance of further research to evaluate the long-term benefits and risks of bariatric surgery in the treatment of type 2 diabetes.