Stampede III: Standing the Test of Time

From Moondancefilmfestival.com

Readers of this Blog are quite familiar with the ongoing results of the Stampede trial.  This is a trial following 150 obese patients with uncontrolled DM2 who were randomized to either have Intensive Medical Therapy (IMT) alone, or IMT and either Roux-en-Y Gastric Bypass or Sleeve Gastrectomy.

Previously published data, inclusive of 2 years of data,  demonstrated substantial improvement in DM2 in the IMT plus bariatric surgery group.

Great, but will it stand the test of time?

Now that the study is 3 years old, new data is available.

Exciting as the results are for improved blood sugar control and secondary end points (weight, antidiabetic med usage, quality of life measures), they more represent a continuation in effect than anything new.

Some highlights of the study to review and update the data:

1.  Mean age of the group was 48 y/o, 68% were women

2.  Mean baseline A1C was 9.3

3.  Mean baseline BMI was 36

4.  At 3 years:
 
     *Endpoint of A1C of 6.0% or less was achieved in 5% of the IMT group, as opposed to 38% of the Bypass + IMT group, and 24% of the Sleeve group

     *Use of meds for DM2, including insulin, was lower in the surgical groups than the IMT group alone

     *Patients in the surgical groups had a greater mean percentage reduction in their baseline weight- with 24% reduction in the Bypass group, and 21% in the Sleeve group, vs. only 4% in the medically treated group

     *Quality of life measures were greater for the surgical groups than the medical group

     *No major late surgical complications were reported

Now how does this new "boring" clinical trial update compare with your non-surgical obese diabetic patients' experiences and quality of life lately?

Probably boring is not the word to describe that...