Patients with diabetes and severe obesity who underwent bariatric surgery had 40 percent less likely to have a heart attack or stroke within 5 years than those with normal medical care, according to a new study published today in for their diabetes. JAMA .
During the same period, operated-in patients were also less likely to suffer from heart disease by more than a third and two-thirds less likely to die from any cause. This research was conducted on four systems of the Health Care Systems Research Network: Kaiser Permanente in Washington, Northern California and Southern California, and HealthPartners Institute in Minnesota
The findings are important because about 30 million ̵
"For most people with diabetes and severe obesity, lifestyle changes and medication may not succeed in significantly reducing these risks," said internist and according to author David Arterburn, MD, MPH, a senior researcher at Kaiser Permanente Washington Health Research institutions. "So we are very pleased with our findings, which suggest that bariatric surgery can reduce new heart attack and stroke cases as well as the risk of death from all causes."
Members of the same research team had shown that diabetes persists long-term remission (for an average of 7 years) for about half of those who undergo gastric bypass, one of the most common bariatric procedures. Last month Annals of Internal Medicine these researchers also reported that people with diabetes undergoing bariatric surgery have half the risk for small blood vessel diseases of the feet, hands, kidneys and eyes within the first 5 years after the surgery, compared with the usual medical treatment of diabetes
The new study included 5,054 Kaiser Permanente and 247 HealthPartners patients with diabetes and severe obesity (a body mass index or BMI of at least 35 kg / m2) receiving bariatric surgery. This included a matched control group of nearly 15,000 patients who had similar characteristics but were given usual medical care for their weight and diabetes instead of bariatric surgery.
"The large size of our study gives it the statistical ability to examine important health outcomes." said senior author Stephen Sidney, MD, director of research hospitals of the Kaiser Permanente Division of Research in Northern California. "Another strength is the long follow-up and comprehensive information from our healthcare systems that provide integrated care and care."
But the study is observational, not a randomized clinical trial, so it can not definitely prove that bariatric surgery causes the decrease in rates of heart attack, stroke, heart disease and death.
"Ideally, randomized clinical trials would confirm or refute our findings," said Bariatric Surgeon and lead author David P. Fisher, MD, the inter-regional chairman of Kaiser Permanente Bariatric Surgery before his recent retirement. "However, such studies are expensive and difficult to perform, and they probably could not be done with enough patients to assess these relatively rare outcomes."
"Our findings add to the evidence that conversations between people with diabetes and serious illnesses should convey to obesity and their health care providers about the potential benefits and risks of weight loss surgery," Dr. Arterburn. "We hope this helps them make better informed decisions about their care."
Bariatric surgery combined with a significant reduction in microvascular complications in type 2 diabetes