While bariatric surgery provides clear benefits in obese people with type 2 diabetes, it is also responsible for significant long-term side effects that require patient screening and prolonged monitoring.
In obese patients with type 2 diabetes, bariatric surgery reduces risk of death from all causes by 49%, according to new study from the University of Gothenburg. With regard to cardiovascular diseases, and in particular myocardial infarction and heart failure, the risk is reduced by 34% in the bariatric surgery group.
There is also a significant decrease in the risk of hyperglycemia, limb amputations, kidney disease and cancer. However, this benefit cannot be generalized to all patients. In addition, because of its late side effects, bariatric surgery requires appropriate and prolonged monitoring. So far, studies of bariatric surgery have not provided much data on the long-term beneficial and negative impact.
This study was presented at the annual congress of the European Association for the Study of Diabetes (EASD) in Berlin.
A national study
The researchers followed for 9 years a Swedish national cohort of obese treated by bariatric surgery. The cohort was assembled by merging data from the Scandinavian Obesity Surgery Registry, the National Diabetes Registry and national databases.
Thanks to this cohort, they were able to compare over an average of 9 years of follow-up obese patients suffering from type 2 diabetes and having had bariatric surgery (5321 patients), with those who had not been treated surgically for obesity. (5321 patients).
Short and long term complications
A number of short-term complications are more common after bariatric surgery: gallstones and gallbladder disease (2.5 times higher risk), gastrointestinal ulcer and reflux (5.4 times), intestinal obstruction ( 9.5 times). Abdominal pain and gastrointestinal disturbances are also more common in the bariatric surgery group and often required additional surgery (3.3 times higher risk).
In the long term, it appears that bariatric surgery increases the risk of anemia by 92% and makes patients three times more at risk of suffering from malnutrition. In addition, people who have operated on are 33% more likely to have a psychiatric problem or addiction to alcohol (three times more often than in the control group).
Better assessment of risks and benefits
This national study confirms the benefits of bariatric surgery, but sheds light on the frequency of undesirable effects that can occur following surgery in obese people with type 2 diabetes. Having this information should help doctors to understand. make more informed decisions when selecting candidates for surgery and enable them to better organize the follow-up and support to be made available to patients.
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