Abstract
Background: Clinical trials have shown that bariatric surgery (BS) is associated with better glycemic control and diabetes remission in patients with type 2 diabetes (T2D) compared with routine care.
Objective: We conducted a real-world population-based study examining the impact of BS on glycemic control and medications in patients with T2D.
Setting and Methods: This was a retrospective, matched, controlled cohort study conducted between January 1, 1990, and January 31, 2018, using IQVIA Medical Research Data, a primary care electronic records database. Adults with body mass index (BMI) ≥30 kg/m 2 and T2D who had BS (surgical) were matched for age, sex, BMI, and diabetes duration to two controls (with T2D and no BS).
Results: A total of 1126 patients in the surgical group and 2219 patients in the control group were analyzed. Mean (standard deviation) age was 50.0 (9.3) years, 67.6% were women, baseline glycocylated hemoglobin (HbA1C) was 7.8% (1.7 mmol/mol), and diabetes duration was 4.7 years (range, 2.0–8.4 years). Over a median (interquartile range) follow-up of 3.6 years (1.7–5.9 years), a higher proportion of patients in the surgical group achieved an HbA1C of ≤6.0% than the control group (65.8% versus 22.8%). The surgical group showed a decrease in mean HbA1C of 1.5% (95% confidence interval [CI]: 1.4%–1.7%), 1.4% (1.2%–1.5%), and 1.3% (1.1%–1.5%) at 1-, 2-, and 3-year follow-up, respectively, whereas HbA1C increased in the control group. The proportion of patients receiving glucose-lowering medications decreased in the surgical group (92.2% to 66.5%) but increased in the control group (85.3% to 90.2%).
Conclusion: BS is associated with significant improvement in glycemic control, achievement of normal HbA1C levels, and reduced need for glucose-lowering therapy in patients with T2D.
| Original language | English |
|---|---|
| Journal | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery |
| Early online date | 8 Aug 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 8 Aug 2022 |
Bibliographical note
Funding Information:K. Nirantharakumar received funding from AstraZeneca, United Kingdom (RSBD20464) and reports fees from Sanofi, United States and Boehringer Ingelheim outside the submitted work. A.A. Tahrani reports grants from Novo Nordisk, personal fees from Novo Nordisk, nonfinancial support from Novo Nordisk, personal fees from Eli Lilly, nonfinancial support from Eli Lilly, personal fees from Janssen, personal fees from AstraZeneca, nonfinancial support from AstraZeneca, nonfinancial support from Impeto Medical, nonfinancial support from Resmed, nonfinancial support from Aptiva, personal fees from Boehringer Ingelheim, nonfinancial support from Boehringer Ingelheim, personal fees from Bristol Myers Squibb, nonfinancial support from Bristol Myers Squibb, personal fees from Napp Pharmaceuticals, nonfinancial support from Napp Pharmaceuticals, personal fees from Merck Sharp & Dohme, nonfinancial support from Merck Sharp & Dohme, personal fees from Nestle, personal fees from Gilead, United Kingdom, grants from Sanofi, and personal fees from Sanofi outside the submitted work. A.A. Tahrani is currently an employee of Novo Nordisk. This work was performed before A.A. Tahrani had become a Novo Nordisk employee, and Novo Nordisk had no role in this project. S. Bellary has received consultation and/or lecture fees from Sanofi Aventis, Astra Zeneca, Eli Lilly, Boehringer Ingelheim, Napp Pharmaceuticals, and Merck Sharp & Dohme and grants and personal fees from Novo Nordisk Ltd, Denmark. outside the submitted work. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2022 American Society for Metabolic and Bariatric Surgery
Keywords
- Bariatric surgery
- Obesity
- Diabetes
- Glycaemic
- HbA1c
- Weight
- Glucose lowering medications
- adult
- Glycemic
- Glucose-lowering medications
- HbA1C
ASJC Scopus subject areas
- Surgery
