Can Bariatric Surgery Affect More Than Just Blood Glucose Control in Diabetics?

Although bariatric surgery improves blood glucose control in patients with type 2 diabetes (NEJM JW Gen Med Apr 1 2017 and N Engl J Med 2017; 376:641), evidence is less robust about whether this surgical intervention prevents microvascular complications of type 2 diabetes. Investigators used four large patient databases to retrospectively compare ≈4000 obese diabetic patients (body-mass index [BMI], ≥35 kg/m²) who underwent bariatric surgery — mostly gastric bypass (76%), sleeve gastrectomy, or adjustable gastric banding — to ≈11,000 patients matched by age, sex, insulin use, and BMI who were managed medically for diabetes. Median follow-up was 4.3 years.

Patients who underwent bariatric surgery had significantly lower incidence of new micro…