Metabolic Surgery Bests Medical Treatment for Microvascular Complications in Diabetes

Metabolic surgery is superior to medical treatment for the prevention of microvascular complications, including diabetic nephropathy, neuropathy, and retinopathy, in patients with type 2 diabetes, according to the results of a recent meta-analysis.

Of the 1559 potential articles identified for analysis, the researchers ultimately evaluated 10 studies (N = 17,532) that had investigated the effects of metabolic surgery vs guideline-based medical treatment on the incidence of microvascular complications in patients with diabetes.
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Study data were obtained via MEDLINE, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL).

Results showed that metabolic surgery was associated with a 4-fold decreased incidence of microvascular complications compared with medical treatment. In particular, metabolic surgery was associated with improvements in pre-existing diabetic neuropathy compared with medical treatment.

In patients who had pre-existing diabetic nephropathy, surgery had improved kidney damage 15-fold compared with medical treatment.

“In patients with [type 2 diabetes mellitus], metabolic surgery prevented the development of microvascular complications better than medical treatment,” the researchers concluded. “Metabolic surgery improved pre-existing diabetic nephropathy compared with medical treatment.”

—Christina Vogt

Reference:

Billeter AT, Scheurlen KM, Probst P, et al. Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus [Published online February 5, 2018]. BJS. doi:10.1002/bjs.10724.