Long-term Effects of Bariatric Surgery in Severely Obese Patients with Type 2 Diabetes

In this meta-analysis, researchers explored the long-term outcomes of macrovascular diseases and metabolic indicators of bariatric surgery in severely obese patients with type 2 diabetes. The Cochrane Library, PubMed, and Embase databases were queried for studies published through January 31, 2019. Randomized clinical trials and cohort studies with at least five years of data comparing bariatric surgery versus conventional medical therapy for long-term incidence of macrovascular events and metabolic outcomes in severely obese patients with type 2 diabetes were included. Final analysis included 10 studies: four randomized trials and six cohort studies. Compared with patients who received conventional treatment, those who underwent bariatric surgery had lower incidence of macrovascular complications (relative risk [RR], 0.43; 95% confidence interval [CI], 0.26-0.61), cardiovascular events (hazard ratio, 0.52; 95% CI, 0.39-0.71), and myocardial infarction (RR, 0.40; 95% CI, 0.26-0.61). Bariatric surgery was also associated with better long-term weight and glycemic control compared with non-operative treatments. Different surgical techniques were associated with different effects on metabolic indicators.