Aim: To assess the
impact of bariatric surgery (BS) on incident microvascular complications [diabetes-related
foot disease (DFD), sight threatening diabetic retinopathy (STDR), chronic
kidney disease (CKD)] in patients with type 2 diabetes and obesity.
<p>Methods: <a>A retrospective matched, controlled population-based cohort
study of adults with type 2 diabetes between 1/1/1990 and 31/1/2018 using </a><a>IQVIA Medical Research Data (IMRD), </a>a database of primary
care electronic records. <a>Each patient with type2 diabetes
who subsequently had BS (surgical) was matched on index date with up to 2
patients with type 2 diabetes did not have BS (non-surgical) within the same
general practice by age, sex, pre-index body mass index and diabetes duration</a>.</p>
<p>Results: 1126 surgical
and 2219 non-surgical participants were included. In the study population, 2261
(68%) were women; Mean (SD) age was 49.87 (9.3) vs 50.12 (9.3) years and BMI
was 46.76 (7.96) kg/m<sup>2</sup> vs 46.14 (7.49) kg/m<sup>2</sup> in surgical
vs non-surgical group respectively. In surgical group, 22.1%, 22.7%, 52.2% and
1.1% patients had gastric band, sleeve gastrectomy, gastric bypass &
duodenal switch respectively.</p>
<p>Over median (IQR) follow-up
was 3.9 years (1.8-6.4), BS was associated with reduction in incident combined
microvascular complications (adjusted HR 0.63, 95% CI 0.51 to 0.78, p<0.001),
DFD (0.61, 0.50 to 0.75, p<0.001), STDR (0.66, 0.44 to 1.00, p<0.001),
CKD (0.63, 0.51 to 0.78, p<0.001). Analysis based on the type of surgery
showed that all types of surgery were associated with favourable impact on the
incident of composite microvascular complications, greatest reduction RYGB.</p>
<p>Conclusions: BS
was associated with a significant reduction in incident diabetes-related
microvascular complications. </p>
Incidence of type 2 diabetes after bariatric surgery: population-based matched cohort study