The Impact of Bariatric Surgery on Incident Microvascular Complications in Patients With Type 2 Diabetes: A Matched Controlled Population-Based Retrospective Cohort Study.

Singh, Pushpa, Adderley, Nicola J, Subramanian, Anuradhaa, Gokhale, Krishna, Singhal, Rishi, Toulis, Konstantinos A, Bellary, Srikanth, Nirantharakumar, Krishnarajah and Tahrani, Abd A (2021) The Impact of Bariatric Surgery on Incident Microvascular Complications in Patients With Type 2 Diabetes: A Matched Controlled Population-Based Retrospective Cohort Study. Diabetes care, 44 (1). pp. 116-124. ISSN 1935-5548. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://care.diabetesjournals.org/content/44/1/116...

Abstract

OBJECTIVE

To assess the impact of bariatric surgery (BS) on incident microvascular complications of diabetes-related foot disease (DFD), sight-threatening diabetic retinopathy (STDR), and chronic kidney disease (CKD) in patients with type 2 diabetes and obesity.

RESEARCH DESIGN AND METHODS

A retrospective matched, controlled population-based cohort study was conducted of adults with type 2 diabetes between 1 January 1990 and 31 January 2018 using IQVIA Medical Research Data (IMRD), a database of primary care electronic records. Each patient with type 2 diabetes who subsequently had BS (surgical group) was matched on the index date with up to two patients with type 2 diabetes who did not have BS (nonsurgical group) within the same general practice by age, sex, preindex BMI, and diabetes duration.

RESULTS

Included were 1,126 surgical and 2,219 nonsurgical participants. In the study population 2,261 (68%) were women. Mean (SD) age was 49.87 (9.3) years vs. 50.12 (9.3) years and BMI was 46.76 (7.96) kg/m vs. 46.14 (7.49) kg/m in the surgical versus nonsurgical group, respectively. In the surgical group, 22.1%, 22.7%, 52.2%, and 1.1% of patients had gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass (RYGB), and duodenal switch, respectively. Over a median follow-up of 3.9 years (interquartile range 1.8-6.4), BS was associated with reduction in incident combined microvascular complications (adjusted hazard ratio 0.53, 95% CI 0.43-0.66, < 0.001), DFD (0.61, 0.50-0.75, < 0.001), STDR (0.66, 0.44-1.00, = 0.048), and CKD (0.63, 0.51-0.78, < 0.001). Analysis based on the type of surgery showed that all types of surgery were associated with a favorable impact on the incidence of composite microvascular complications, with the greatest reduction for RYGB.

CONCLUSIONS

BS was associated with a significant reduction in incident diabetes-related microvascular complications.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > Diabetes
Ambulatory Care > Endocrinology
Planned IP Care > General Surgery
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Depositing User: Mrs Yolande Brookes
Date Deposited: 20 Jan 2021 13:00
Last Modified: 18 Feb 2021 12:09
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3865

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