Singh, Pushpa, Adderley, Nicola J., Subramanian, Anuradhaa, Gokhale, Krishna, Hazlehurst, Jonathan, Singhal, Rishi, Bellary, Srikanth, Tahrani, Abd A. and Nirantharakumar, Krishnarajah (2022). Glycemic outcomes in patients with type 2 diabetes after bariatric surgery compared with routine care:a population-based, real-world cohort study in the United Kingdom. Surgery for Obesity and Related Diseases, 18 (12), pp. 1366-1376.
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.
Publication DOI: | https://doi.org/10.1016/j.soard.2022.08.001 |
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Divisions: | College of Health & Life Sciences > School of Biosciences College of Health & Life Sciences College of Health & Life Sciences > Chronic and Communicable Conditions Aston University (General) |
Additional Information: | © 2022, Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery. This accepted manuscript version is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License https://creativecommons.org/licenses/by-nc-nd/4.0/ |
Uncontrolled Keywords: | Adult,Humans,Female,Middle Aged,Male,Diabetes Mellitus, Type 2/complications,Glycated Hemoglobin A/analysis,Cohort Studies,Retrospective Studies,Treatment Outcome,Bariatric Surgery,Blood Glucose,United Kingdom/epidemiology,Surgery |
Publication ISSN: | 1878-7533 |
Last Modified: | 02 Dec 2024 08:42 |
Date Deposited: | 24 Aug 2022 14:55 |
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Related URLs: |
https://www.sci ... 550728922006074
(Publisher URL) http://www.scop ... tnerID=8YFLogxK (Scopus URL) |
PURE Output Type: | Article |
Published Date: | 2022-12 |
Published Online Date: | 2022-08-08 |
Accepted Date: | 2022-08-01 |
Authors: |
Singh, Pushpa
Adderley, Nicola J. Subramanian, Anuradhaa Gokhale, Krishna Hazlehurst, Jonathan Singhal, Rishi Bellary, Srikanth ( 0000-0002-5924-5278) Tahrani, Abd A. Nirantharakumar, Krishnarajah |
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