Patients with obesity and either prediabetes or type 2 diabetes saw a reduced, long-term risk for microvascular complications after undergoing bariatric Weight Loss Surgery compared with similar patients who received usual care, according to findings in a Swedish study.“Bariatric Weight Loss Surgery prevents microvascular complications in obese patients with a glucose status ranging from normal to established type 2 diabetes, and the greatest [RR] reduction is obtained in those with prediabetes,” Lena M. S. Carlsson, MD, PhD, of the Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden, told Endocrine Today. “In obese patients with prediabetes, bariatric Weight Loss Surgery prevented microvascular complications in those that remained free from diabetes, indicating that long-term exposure to slightly elevated glucose levels (below the cutoff for diabetes) is harmful.”
Carlsson and colleagues analyzed data from 4,032 patients aged 37 to 60 years recruited for the nonrandomized Swedish Obese Subjects (SOS) study between September 1987 and January 2001. Included men had a BMI of at least 34 kg/m²; included women had a BMI of at least 38 kg/m². Patients were stratified by four groups: Normal glucose tolerance (fasting blood glucose concentration < 5 mmol/L); prediabetes (5-6 mmol/L); screen-detected type 2 diabetes (≥ 6.1 mmol/L without a previous diagnosis) and established type 2 diabetes diagnosed before study enrollment. Within the surgery group (n = 2,001), 265 patients underwent gastric bypass; 376 underwent gastric banding; 1,369 underwent vertical-banded gastroplasty.