Researchers in Hong Kong recently conducted a study of patients who either had or had not received bariatric surgery to better understand the effectiveness of such procedures and monitor outcomes in patients during a 5-year period. They found that both restrictive and gastric bypass surgeries were effective in promoting weight loss, diabetes remission, and dyslipidemia in patients, according to data published in Diabetes/Metabolism Research and Reviews.
The aims of the study were to discover the efficacy of bariatric surgery for remission of diseases related to obesity, estimate metabolic changes over the course of 5 years, and compare the outcomes of restrictive and gastric bypass surgeries. The 668 participants in the study had type 2 diabetes and had undergone bariatric surgery at some point between 2006 and the end of 2017. These patients were compared with a control group of obese patients who have never undergone any type of bariatric surgery. All participants were observed for up to 60 months. The researchers monitored remission of diabetes, hypertension, dyslipidemia, cholesterol levels, and triglyceride levels, as well as secondary outcomes such as blood pressure and body weight. Disease relapses after initial remission were also noted.
Although only half the initial study population was available at the end of the follow-up period, the researchers discovered that the rates of complete diabetes remissions for those who underwent bariatric surgery were much higher than the rates of those in the control group (26.4% at peak vs 3.5%). Results showed no difference in rates of hypertension between surgery and nonsurgery groups. Metabolic parameters, such as hemoglobin A1c, diastolic blood pressure, systolic blood pressure, and low-density lipoprotein cholesterol, differed significantly between the 2 groups. At the 5-year study endpoint, the mean body mass index for those in the surgery group had dropped from 36.81 kg/m2 at baseline to 32.21 kg/m2. There was no significant difference observed between remission rates for restrictive and bypass surgeries at the endpoint of the study.
Researchers noted that the results of the study may be limited by the 5-year follow-up period, expressing that a follow-up of a decade or more would be preferred. In addition, patients who are candidates for bariatric surgery may be those for whom first-line therapies were not effective, making true comparison between the surgery and control groups somewhat difficult.
Wu T, Wong SKH, Law BTT, et al. Five‐year effectiveness of bariatric surgery on disease remission, weight loss, and changes of metabolic parameters in obese patients with type 2 diabetes: A population‐based propensity score‐matched cohort study [published ahead of print January 7, 2020]. Diabetes Metab Res Rev. doi:10.1002/dmrr.3236