Impact of Bariatric Surgery on Microvascular Complications of Type 2 Diabetes

Sarfaroj Khan 

Disclosures

October 30, 2020

Takeaway

Why this matters

  • Bariatric surgery is an effective treatment for the remission of T2D and has long-term benefits for major macrovascular and microvascular events.

  • However, there are limited studies assessing early outcomes in relation to microvascular complications, particularly neuropathy.

Study design

  • This prospective observational cohort study assessed microvascular complications (especially neuropathy) in obese patients with T2D (n=26) before and 12 months after bariatric surgery.

  • Funding: None disclosed.

Key results

  • There was a significant reduction in body mass index (BMI) post-bariatric surgery (47.2 to 34.5 kg/m2; P<.001).

  • There were significant improvements after surgery in:

    • corneal nerve fibre density (27.1 to 29.2/mm2; P=.005);

    • corneal nerve branch density (63.4 to 77.8/mm2; P=.008);

    • corneal nerve fibre length (CNFL; 20.0 to 20.2/mm2; P=.001);

    • neuropathy symptom profile (3 to 0/38; P<.001), and

    • estimated glomerular filtration rate cyst-creat (ΔeGFRcyst-creat; 128 to 120 mL/min; P=.015).

  • Changes in (Δ) triglycerides independently correlated with ΔCNFL (β=−0.53; P=.024) and ΔSBP (β=0.62; P=.017) and % excess BMI loss (β=−0.004; P=.018) were linked with ΔeGFRcyst-creat.

  • No significant changes were observed in the neuropathy disability score, vibration perception threshold, cold perception threshold, warm perception threshold, nerve conduction studies, urinary albumin/creatinine ratio and retinopathy status.

  • Glomerular hyperfiltration resolved in 5 of the 12 patients with this condition pre-operatively.

Limitations

  • Small sample size and lack of a matched control group.

 

Adam S, Azmi S, Ho JH, Liu Y, Ferdousi M, Siahmansur T, Kalteniece A, Marshall A, Dhage SS, Iqbal Z, D'Souza Y, Natha S, Kalra PA, Donn R, Ammori BJ, Syed AA, Durrington PN, Malik RA, Soran H. Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study. Obes Surg. 2020 Oct 26 [Epub ahead of print]. doi: 10.1007/s11695-020-05052-8. PMID: 33104989 View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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