By Colin Kenny, Editor – Diabetes Distilled
Bariatric surgery improves glycaemic control and may modify cardiovascular risk in type 2 diabetes (T2D), but less is known about microvascular outcomes. Researchers performed a cohort study to examine the relationship between bariatric surgery and microvascular complications from T2D. All participants had T2D, and those who had bariatric surgery were matched with a control group who had not had the procedure. These cohorts were followed for up to 7 years, at the end which the incidence of microvascular disease was lower in the bariatric surgery group.
In the study, 4,024 patients with T2D aged 19–79 years who had undergone bariatric surgery were matched on age, sex, BMI, HbA1c level, diabetes duration, insulin use and intensity of health care to 11,059 nonsurgical participants with T2D. At 1, 3, 5 and 7 years, the rates of incident microvascular disease were 6.0%, 11.8%, 16.9% and 22.5%, respectively, after bariatric surgery compared with 11.2%, 24.3%, 34.7% and 44.2%, after usual medical care.
This difference was primarily driven by the incidence of neuropathy, which was significantly lower in patients who had undergone bariatric surgery. Rates of retinopathy were also lower in this group.
The investigators concluded that bariatric surgery not only improves HbA1c, blood pressure and lipid control, but is likely to reduce macrovascular and microvascular complications, as well as improving survival, in patients with severe obesity and T2D.
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