Bariatric Surgery Cuts Incidence of Type 2 Diabetes in Obese
Surgery especially effective for those with impaired fasting glucose
WEDNESDAY, Aug. 22 (HealthDay News) -- Bariatric surgery is very effective in reducing the long-term incidence of type 2 diabetes in obese individuals, according to a study published in the Aug. 23 issue of the New England Journal of Medicine.
Lena M.S. Carlsson, M.D., Ph.D., from the University of Gothenburg in Sweden, and colleagues compared the rates of type 2 diabetes in 1,658 patients who underwent bariatric surgery and 1,771 obese matched controls who received usual care. None of the patients had diabetes at baseline; they ranged from 37 to 60 years old; and all had a body mass index (BMI) of at least 34 kg/m² for men and 38 kg/m² for women.
During up to 15 years of follow-up, the researchers found that type 2 diabetes developed in 392 control patients but only 110 bariatric surgery patients (incidence rate, 28.4 versus 6.8 per 1,000 person-years; adjusted hazard ratio for bariatric surgery, 0.17). The presence or absence of impaired fasting glucose had a significant impact on the effect of bariatric surgery, but BMI did not. Postoperative mortality was 0.2 percent, and 2.8 percent of bariatric surgery patients required additional surgery due to complications.
"Our data indicate that bariatric surgery has a preventive effect on incident type 2 diabetes, particularly in participants with impaired fasting glucose," Carlsson and colleagues conclude. "Baseline BMI did not influence the preventive effect of bariatric surgery on type 2 diabetes, implying that anthropometric data are not useful in the selection of candidates for bariatric surgery, whereas data on impaired fasting glucose may be helpful."
Several authors disclosed financial ties to the biotechnology, weight loss, and pharmaceutical industries. The Swedish Obese Subjects study was funded by the pharmaceutical industry.