Metabolic effects of bariatric surgery on patients with type 2 diabetes: a population-based study

BackgroundBariatric surgery among patients with obesity and type 2 diabetes (T2D) can induce complete remission. However, it remains unclear whether sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) has better T2D remission within a population-based daily practice.ObjectivesTo compare undergoing RYGB SG on the extent of at 1-year follow-up.SettingNationwide, study including all 18 hospitals in Netherlands providing metabolic bariatric surgery.MethodsPatients between October 2015 2018 1 year follow-up data were selected from mandatory nationwide Dutch Audit for Treatment Obesity (DATO). The primary outcome is year. Secondary outcomes include ≥20% total weight loss (TWL), obesity-related co-morbidity reduction, postoperative complications Clavien-Dindo (CD) grade ≥III 30 days. We compared groups using propensity score matching to adjust confounding by indication.ResultsA 5015 identified DATO, 4132 (82.4%) had completed visit. There 3350 (66.8%) valid status who included analysis (RYGB = 2623; 727). lower body mass index than patients, but more often female, higher gastroesophageal reflux disease dyslipidemia rates. After adjusting these confounders, increased odds achieving (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.14–2.1; P < .01). Groups balanced after 695 each group. matching, still (OR, 1.91; CI, 1.27–2.88; Also, significantly ≥20%TWL 2.71; 1.96–3.75; .01) rates 1.96; 1.39–2.76; no significant differences CD complications.ConclusionUsing Netherlands, this shows that leads practice.