Evaluate the outcomes of bariatric surgery compared to SGLT2 inhibitors and GLP1 analogues in managing obesity and diabetes in adults. TriNetX data formed two cohorts: Cohort A (115,954 patients) on SGLT2/GLP1 therapy, and Cohort B (20,166 patients) post-bariatric surgery. Outcomes included hospitalization, DKA events, HbA1c levels, and hypoglycemic events over five years. Cohort B showed higher hospitalization risk (4.1%) compared to Cohort A (1.8%, p< 0.001). No mortality was observed in either cohort. Cohort B achieved better HbA1c control (mean: 6.439) than Cohort A (mean: 7.206, p< 0.001). DKA events were marginally higher in Cohort B (0.001%) than in Cohort A (0.000%, p=0.068). Cohort B had a slightly higher risk of hypoglycemic events (1.0%) than Cohort A (0.7%, p< 0.001). Bariatric surgery showed better glycemic control but higher risks of hospitalization and hypoglycemia compared to SGLT2/GLP1 therapies. These findings underscore the need for personalized treatment approaches in obese diabetic patients, balancing glycemic control against treatment-associated risks.
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Al-Sudani et al. (2024) studied this question.
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