Bariatric Surgery Does Not Exacerbate and May Be Beneficial for the Microvascular Complications of Type 2 Diabetes

The effects of bariatric surgery on microvascular complications remain underexplored despite more than 40 years of surgery on patients with type 2 diabetes. The literature has focused predominantly on glycemic control and very little on diabetes-related complications, which confer high rates of morbidity and mortality. Our aim was to assess whether the gastric bypass, sleeve gastrectomy, and gastric banding procedures are safe for the retinal and renal complications of type 2 diabetes, especially as they lead to rapid improvements in glycemia, which may paradoxically cause or exacerbate microvascular complications. Prospectively collected retinal photographs (two-field) and urine albumin creatinine ratios (ACRs) were analyzed retrospectively in 84 consecutive patients with type 2 diabetes before and 12–18 months after surgery. The results were confirmed by an independent ophthalmologist who was blinded to clinical information. Improvement or deterioration was defined as a decrease or increase of at least two …