A RECENT study highlights the long-term benefits of bariatric surgery in preventing the progression from pre-diabetes to Type 2 diabetes (T2D).
While literature on this topic has been limited, this retrospective analysis provides robust data on the efficacy of bariatric procedures, specifically Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), in mitigating the risk of developing T2D in patients who are morbidly obese.
The study followed 1,326 patients with pre-diabetes who underwent either RYGB (1,154 patients) or SG (172 patients) between 2001–2022. These patients were compared to a matched group of non-surgical controls who had similar characteristics, including age, sex, BMI, and haemoglobin A1c levels. The aim was to compare the incidence of T2D conversion over time.
Results revealed that the conversion rate to T2D was significantly lower in bariatric surgery patients compared to non-surgical controls. After 5 years, only 1.8% of patients who had undergone surgery progressed to T2D, a figure that increased to 3.3% after 10 years and 6.7% at 15 years. In contrast, the T2D conversion rates for non-surgical patients were substantially higher at 31.1%, 51.4%, and 68.7% at the same time intervals, respectively. This equates to a 20-fold higher risk of developing T2D for those not undergoing surgery (hazard ratio: 19.8; P<0.0001).
Additionally, the study found that patients who had SG were four times more likely to develop T2D compared to those who had RYGB (hazard ratio: 4.01; P=0.0014), suggesting that RYGB may offer superior protection against the conversion to diabetes.
These findings strongly support bariatric surgery as an effective intervention for reducing the risk of T2D in patients with pre-diabetes, with RYGB showing the most favourable outcomes. Clinicians should consider the significant long-term benefits of bariatric surgery in managing obesity-related diabetes risk.
Ada Enesco, EMJ
Reference
Nguyen-Lee JJ et al. The long term (15 year) impact of bariatric surgery on conversion from pre-diabetes to type II diabetes mellitus. A420. American Society for Metabolic and Bariatric Surgery Annual Meeting, 9-13 June, 2024.
