Diabetes Care: Bariatric surgery will halve the mortality rate. Which surgery is more conducive to the cardiovascular outcome of diabetic patients?

Diabetes (DM) is considered by the World Health Organization (WHO) as one of the four major non-communicable diseases
.

Currently, there are 463 million DM patients worldwide

Diabetes mellitus (DM) is considered by the World Health Organization (WHO) as one of the four major non-communicable diseases

Among them, China is the country with the most DM patients, with approximately 116 million patients

Lancet This means that there is hope for curing T2DM, which is believed to require lifelong medication

In order to further determine the two most common metabolic surgery (Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG)), which one is related to the main disadvantages of T2DM and obesity patientsHeart blood vessels to reduce events (MACE) risks associated
.

The recent Diabetes Care published relevant results

Heart blood vessels

The researchers analyzed a total of 13,490 patients, including 1,362 RYGB, 693 SG, and 11,435 T2DM and obesity matched non-surgical patients (1998-2017) who were treated at the Cleveland Clinic.
They were followed up to December 2018
.

Through multivariate Cox regression analysis, the time to the occurrence of extended MACE was estimated, which was defined as the first occurrence of coronary artery event, cerebrovascular event, heart failure , kidney disease, atrial fibrillation and all-cause death

Heart failure

The results showed that the cumulative incidence of the primary endpoint within 5 years in the RYGB group was 13.
7% (95% CI, 11.
4-15.
9), and the SG group was 24.
7% (95% CI, 19.
0-30.
0), and the risk of RYGB was reduced by 23% (HR=0.
77) ; 95%CI, 0.
60-0.
98)
.

Among the six individual endpoints, the cumulative incidence of renal disease after 5 years in RYGB was significantly lower than that of SG (2.

The results showed that the cumulative incidence of the primary endpoint within 5 years in the RYGB group was 13.

Compared with routine care, the incidence rate of MACE in RYGB and SG patients in 5 years

In addition, RYGB is associated with greater reductions in body weight, glycosylated hemoglobin, and medications used to treat diabetes and cardiovascular disease
.

Five years after RYGB, compared with SG, patients required more upper endoscopy (45.

In addition, RYGB is associated with greater reductions in body weight, glycosylated hemoglobin, and medications used to treat diabetes and cardiovascular disease

In summary, among obese and T2DM patients, compared with SG, RYGB may be associated with greater weight loss, better diabetes control, and a lower risk of MACE and kidney disease

references:

Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity: Comparison of Gastric Bypass, Sleeve Gastrectomy, and Usual Care.
Diabetes Care 2021 Sep; dc203023.
https://doi.
org/10.
2337/dc20-3023

Outcomes, in Patients With the Type Cardiovascular 2 Diabetes and Obesity: Comparison of Gastric Bypass, Sleeve gastrectomy, and Usual Care.
Https://doi.
org/10.
2337/dc20-3023 https://doi.
org/10.
2337/dc20-3023 in This message