Practice Update: Endocrinology

CONFERENCE COVERAGE

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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

[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

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

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.

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

PRACTICEUPDATE ENDOCRINOLOGY