Bariatric Surgery Reduces Microvascular Disease in Type 2 Diabetes

Expert discusses bariatric surgery for type 2 diabetes
Expert discusses bariatric surgery for type 2 diabetes
Investigators sought to determine whether bariatric surgery was associated with lower incidence of microvascular disease for patients with T2D and severe obesity.

Bariatric procedures significantly reduced incidents of microvascular disease by reducing occurrences of diabetic neuropathy, nephropathy, and retinopathy, according to a study recently published in the Annals of Internal Medicine.

Researchers analyzed retrospective microvascular disease outcome data on adult patients with type 2 diabetes who underwent a gastric bypass, sleeve gastrectomy, or adjustable gastric banding procedure. Microvascular disease data included incidents of retinopathy, neuropathy, and nephropathy. The researchers also analyzed a control group of adults with type 2 diabetes who matched on baseline characteristics but did not obtain a bariatric surgery. Data was evaluated at time points of 1, 3, 5, and 7 years.

Results indicated that the bariatric surgery arm had a reduced incidence of neuropathy and retinopathy at all time points and nephropathy at all time points after year 1. Occurrences of microvascular disease were lower in the bariatric surgery arm than the usual care arm at 1 year (6% vs 11.2%, respectively), 3 years (11.8% vs 24.3%, respectively), 5 years (16.9% vs 34.7%, respectively), and 7 years (22.5% vs 44.2%, respectively). Occurrences of microvascular disease were significantly lower in the bariatric surgery arm at 5 years (HR, 0.41; 94% CI, 0.34-0.48).

Due to the retrospective nature of this study, inference and cofounders might have impacted results.

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In conclusion, this study adds to the list benefits of bariatric surgery for patients with type 2 diabetes by discovering the reduction of microvascular disease by reducing neuropathy, nephropathy, and retinopathy.

This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Please refer to reference for a complete list of authors’ disclosures.


O’Brien R, Johnson E, Haneuse S, et al. Microvascular outcomes in patients with diabetes after bariatric surgery versus usual care [published online August 7, 2018]. Ann Intern Med. doi:10.7326/M17-2383