Death and heart complications were 40 percent less common in people with obesity and diabetes when they had bariatric surgery
SEATTLE, September 2, 2019—Weight-loss surgery performed in patients with type 2 diabetes and obesity is associated with a lower risk of death and fewer major adverse cardiovascular events than usual medical care, according to a large Cleveland Clinic study with a Kaiser Permanente Washington Health Research Institute (KPWHRI) coauthor. These patients also lost more weight, had better diabetes control, and used fewer medications for treatment of their diabetes and cardiovascular disease than those undergoing usual medical care.
The results were presented as a late-breaking study at the European Society of Cardiology Congress and simultaneously published in the Journal of the American Medical Association (JAMA) as “Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity.”
The observational study looked at nearly 2,300 Cleveland Clinic patients who had metabolic surgery and 11,500 matched patients with similar characteristics who received usual medical care. Patients underwent one of four types of weight-loss surgery (also known as metabolic or bariatric surgery): gastric bypass, sleeve gastrectomy, adjustable gastric banding, or duodenal switch.
Why it matters
These results matter because more than one in three (nearly 40 percent of) Americans has obesity, which is linked to type 2 diabetes heart disease, and stroke. And adults with diabetes are two to four times more likely to die from heart disease than those without diabetes: Heart disease is the leading cause of death for people with obesity and diabetes.
“This is an important paper, validating and extending our prior work in the Health Care Systems Research Network, or HCSRN,” says coauthor David Arterburn, MD, MPH, a KPWHRI senior investigator and internal medicine physician with Washington Permanente Medical Group. “It helps to reinforce the message that patients with type 2 diabetes and severe obesity should be discussing bariatric surgery as a reasonable treatment option for preventing long-term consequences of their diabetes.”