Key result
Bariatric surgery significantly increased the prevalent complete or partial diabetes remission rate to 22.1% compared to approximately 5.0% in matched non-surgical controls at 60 months.
Why the study?
To compare disease remission rates, weight loss, and changes of metabolic parameters between patients after bariatric surgery and nonsurgical patients.
Does bariatric surgery improve disease remission and metabolic parameters in obese patients with type 2 diabetes compared to non-surgical management?
Cohort (n=2,295)
Does bariatric surgery improve disease remission and metabolic parameters in obese patients with type 2 diabetes compared to non-surgical management?
Absolute Event Rate: 22.1% vs 5%
p-value: p=<0.001
Bariatric surgery provides substantial and sustained improvements in weight loss, diabetes remission, and lipid profiles over 5 years in obese patients with type 2 diabetes compared to non-surgical management.
May support metabolic benefits of bariatric surgery in obese T2DM; leaves open need for RCTs on cardiovascular outcomes.
Aims To compare disease remission rates, weight loss, and changes of metabolic parameters of patients after bariatric surgery with nonsurgical patients. Methods Based on the 2006‐2017 Hospital Authority database, a population‐based retrospective cohort of obese type 2 diabetes mellitus (T2DM) patients with and without bariatric surgery were identified. Surgical patients were matched with nonsurgical patients on 1‐to‐5 propensity score. Remission rates of diabetes, hypertension, and dyslipidaemia were reported annually up to 60 months. Changes in weight loss measurements (Body Mass Index [BMI], percentage of total weight loss [%TWL], percentage of excess weight loss [%EWL], and percentage of rebound in excess weight loss [%REWL]) and metabolic parameters (haemoglobin A 1c [HbA 1c ], systolic blood pressure [SBP], diastolic blood pressure [DBP], and low‐density lipoprotein cholesterol [LDL‐C]) were measured for both groups. Results Four hundred one surgical patients (310 restrictive surgeries; 91 bypass surgeries) and 1894 nonsurgical patients were included. Surgical patients had higher remission rates in diabetes and dyslipidaemia and better glycaemic control at 12 to 60 months (all P s < .01). SBP and DBP were significantly lower for surgical group up to 12 months and similar between two groups after 12 months. Surgical patients had significantly lower BMI during follow‐up period. %TWL and %EWL were higher in the surgery group (15.7% vs 3.7%; 48.8% vs 12.0%) at 60 months ( P < .001); differences in %REWL between two groups were insignificant. The effectiveness of restrictive and bypass surgeries was similar at 60 months, although restrictive surgeries were slightly more effective in T2DM remission. Conclusions Bariatric surgery was effective in weight loss, remission of diabetes, and dyslipidaemia in 5‐year post‐surgery.
No takes yet. Share an insight, caveat, or question.
Wu et al. (2020) conducted a cohort in Obese with type 2 diabetes mellitus (n=2,295). Bariatric surgery vs. No bariatric surgery was evaluated on Prevalent diabetes complete or partial remission at 60 months (p=<0.001). Bariatric surgery significantly increased the prevalent complete or partial diabetes remission rate to 22.1% compared to approximately 5.0% in matched non-surgical controls at 60 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: