10 / 16
76th scientific sessions of the
American Diabetes Association
10–14 JUNE 2016 • NEW ORLEANS, LOUISIANA, USA
More than 15,000
leading physicians,
scientists and
health care
professionals from
around the world
attended this year’s
American Diabetes
Association’s
Scientific Sessions to
unveil cutting-edge
research, treatment
recommendations
and advances toward
a cure for diabetes.
PracticeUpdate
reporters share these
highlights.
Bariatric surgery reduces the incidence of retinopathy and nephropathy
in obese patients with type 2 diabetes
Bariatric surgery has been found to be associated with reduced long-term incidence of complications affecting the eyes and kidneys in both patients
with screen-detected and established type 2 diabetes. This conclusion, based on results of outcome of a prospective controlled trial comparing bariatric
surgery and usual care was presented at the ADA 2016.
K
ajsa Sjöholm, PhD, of the University
of Gothenburg, Sweden, explained that
bariatric surgery often causes diabetes
remission in obese patients, especially in
newly diagnosed diabetes.
Dr Sjöholm and colleagues have previously
reported that bariatric surgery also reduces the
incidence of overall macrovascular and micro-
vascular complications in the Swedish Obese
Subjects study, a prospective controlled trial
comparing bariatric surgery and usual care.
The investigators have now analysed the
effects of bariatric surgery on retinopathy,
nephropathy and neuropathy, traced in na-
tionwide registers, in Swedish Obese Subjects
study patients with screen-detected (n = 246)
and established type 2 diabetes (n = 357, mean
duration 5.2 years) followed for up to 26 years.
Bariatric surgery reduced the incidence of
retinopathy in patients with screen-detected
type 2 diabetes [incidence rate 6.3 and 19.2
per 1000 person years in the surgery and
control groups, respectively; hazard ratio
0.27 (0.15–0.50), P < 0.001] and established
type 2 diabetes [incidence rate 25.9 and 46.9
per 1000 person years in the surgery and con-
trol groups, respectively; hazard ratio 0.51
(0.37–0.70), P < 0.001].
The incidence of nephropathy was also re-
duced by bariatric surgery in both subgroups
[screen-detected type 2 diabetes: incidence
rate 3.8 and 9.7 per 1000 person years in
the surgery and control groups, respectively;
hazard ratio 0.37 (0.17–0.81), P = 0.012; es-
tablished type 2 diabetes: incidence rate 18.8
and 9.6 per 1000 person years in the surgery
and control groups, respectively; hazard ratio
0.48 (0.30–0.77), P = 0.002].
Complications affecting nerves were few
and no difference in their incidence between
the surgery and control groups was observed
[screen-detected type 2 diabetes: incidence
rate 2.1 and 3.3 per 1000 person years in the
surgery and control groups, respectively; es-
tablished type 2 diabetes: incidence rate 4.3
and 6.8 per 1000 person years in the surgery
and control groups, respectively].
Dr Sjöholm concluded that bariatric surgery
was shown to be associated with reduced long-
term incidence of complications affecting the
eyes and kidneys both in patients with screen-
detected and established type 2 diabetes.
Bariatric surgery reduced the
incidence of retinopathy in patients
with screen-detected type 2
diabetes and established type 2
diabetes.
CONFERENCE COVERAGE
PRACTICEUPDATE ENDOCRINOLOGY
10