Physical health, quality of life improved with bariatric surgery vs. medical therapy
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Adults with type 2 diabetes who underwent bariatric surgery reported more energy, less fatigue and better general health compared with those assigned to medical therapy, according to new data from the STAMPEDE trial.
“Patient-reported outcomes are determined directly by patients without interpretation by clinicians,” Ali Aminian, MD, associate professor of surgery and director of the Bariatric and Metabolic Institute at Cleveland Clinic, told Healio. “Compared with the general population, patients with chronic disorders such as severe obesity and diabetes have lower quality of life scores and their scores gradually decline over time. It is important to study the effects of different treatment modalities for these chronic conditions on well-being of patients in their daily life.”
Aminian and colleagues analyzed data from 104 adults with type 2 diabetes who underwent Roux-en-Y gastric bypass, sleeve gastrectomy or intensive medical therapy as part of the STAMPEDE trial, a randomized controlled trial assessing long-term effects of type 2 diabetes treatments. Participants completed two general quality of life questionnaires (SF-36 and EQ-5D-3L) and a diabetes-specific instrument at baseline and then on an annual basis up to 5 years after randomization.
Researchers found that participants who underwent Roux-en-Y or sleeve gastrectomy reported improved general health perception, energy/fatigue and diabetes-related quality-of-life compared with those assigned to intensive medical therapy alone.
“None of the quality of life components improved significantly from baseline in the intensive medical therapy group,” the researchers wrote in an abstract.
Researchers observed no differences among the study groups in measures of psychological and social aspects of quality of life. In multivariable analysis, independent factors associated with improved general health perception in the long term were baseline general health (P < .001), not taking insulin at 5 years (P = .005), Roux-en-Y gastric bypass vs. intensive medical therapy (P = .005) and sleeve gastrectomy vs. intensive medical therapy (P = .034). Changes were similar in analyses stratified by surgery type.
“Although it is encouraging that weight loss and improvement in cardiometabolic profile of patients after metabolic surgery led to profound improvement in self-reported physical health, long-term changes in the psychological, emotional and social aspects of quality of life were not so noticeable,” Aminian told Healio. “Our findings suggest that psychological well‐being needs require more attention in metabolic surgical patients.”
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Aminian A, et al. Patient-reported outcomes after metabolic surgery vs. medical therapy for diabetes: Insights from the STAMPEDE randomized trial. Presented at: American Surgical Association annual meeting; April 15-16, 2021 (virtual meeting).
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