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Bariatric surgery appears safe for type 2 diabetes with mild obesity

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LOS ANGELES — Bariatric surgery may be an acceptable option for patients with type 2 diabetes with overweight that does not reach BMI levels considered to be morbid obesity, according to research presented at ObesityWeek 2015.

Efficacy of bariatric surgery as a treatment option for type 2 diabetes has been established in patients with morbid obesity, but clinical studies of efficacy and safety of the procedures in patients with type 2 diabetes have tended to screen out those with lower BMI, although most patients with diabetes fall into this weight category, Ali Aminian, MD, of Cleveland Clinic, said during the presentation.

Aminian and colleagues analyzed data from 2005 to 2013 from the American College of Surgeons National Surgical Quality Improvement Program dataset on 1,003 patients (mean age, 53 years; 74% women) with BMI between 25 kg/m² and 34 kg/m² (mean BMI, 33.5 kg/m²) who were prescribed diabetes medications and underwent elective bariatric surgery. Within the cohort, 46 patients had BMI less than 30 kg/m². Insulin was prescribed for 40% of all patients, 78% had hypertension and 9% had cardiac disease. Roux-en-Y gastric bypass was used by 57% of patients, adjustable gastric band by 23%, sleeve gastrectomy by 19% and duodenal switch by 1%.

Researchers searched for 16 adverse events occurring within 30 days of the procedure and found incidence of individual complications to be less than 0.5%; postoperative bleeding was the exception, with an incidence of 1.6%. The composite adverse event rate was 4.2%, with a 0.2% mortality rate; 1.6% of patients had a surgical revision of the primary procedure within 30 days.

“Our data ... show a modest early morbidity and low mortality following bariatric surgery in nonmorbidly obese patients with type 2 diabetes,” Aminian said. “The main limitation of this study is that the dataset includes only short-term postoperative outcomes, but, as we know, more serious complications are occurring in the initial 30 days following bariatric surgery.”

In a follow-up question-and-answer period, Aminian said further studies should compare outcomes for this patient demographic that receive bariatric surgery with those that do not. – by Jill Rollet

Reference:

Aminian A, et al. Abstract A126. Presented at: ObesityWeek 2015; Nov. 2-6, 2015; Los Angeles.

Disclosure: Aminian reports no relevant financial disclosures.