Bariatric surgery could reduce heart disease risk in diabetics

Author: Adrian O'Dowd
Bariatric surgery could reduce heart disease risk in diabetics

People with type 2 diabetes who undergo weight loss surgery are 70% less likely to develop dangerous types of cardiovascular disease, claims new research*.

Results of the study carried out by researchers at the University of Nottingham were presented today at the Diabetes UK Professional Conference being held in Liverpool.

Benefits of weight loss (bariatric) surgery have been known for some time and for people with type 2 diabetes who are overweight, this treatment has been found to help their diabetes management, by improving the way the body uses insulin. It has also been shown to put type 2 diabetes into remission in 30-60% of cases.

The research team, led by Professor Iskandar Idris, looked at cardiovascular events – including heart disease, heart attack and stroke – from The Health Improvement Network database, with information on 11,125 people with type 2 diabetes in the UK.

They compared 131 people who had bariatric surgery with 579 similar people who had not, and examined their health over a 10-year period. All participants were at first being treated with insulin and their average age was 52.

Over the 10-year period, people in the surgery group were 71% less likely to have developed coronary heart disease. They were also 69% less likely to have peripheral arterial disease (PAD) than the control group.

People with type 2 diabetes who had bariatric surgery lost, on average, 22.5kg five years after the surgery, were more likely to come off insulin, and had better blood pressure and blood glucose levels compared with the control group.

However, the research also showed that bariatric surgery did not appear to reduce the risk of other cardiovascular events the researchers tracked such as heart attack, stroke and heart failure.

Previous studies have shown that surgery can be an effective treatment for some and can be cost-effective for the NHS, but at the moment, bariatric surgery is only offered to a small proportion of people with type 2 diabetes.

Lead author of the study Mohammed Alkharaiji said: “Our data shows that, in the long run, significant overall health improvements are seen after surgery.

“In many cases, this increased the patients’ chances of being able to manage their type 2 diabetes without taking insulin and was accompanied by evidence of a protective effect against potential cardiovascular complications.”

Dr Elizabeth Robertson, director of research at Diabetes UK, said: “We know people with type 2 diabetes are more at risk of developing heart problems and blood vessel damage, so we need to find ways to reduce this risk.

“This study shows that weight loss surgery could be one effective way to do this. While it won’t be suitable for everyone and may not be a treatment of choice for some people living with type 2 diabetes, evidence is building that weight loss surgery should become a more widely accessible treatment option.”

*Abstract: Alkharaiji M, Anyanwagu U, Idris I, and Donnelly R. Effect of bariatric surgery on cardiovascular events and metabolic outcomes in obese patients with insulin-treated Type 2 diabetes: A large retrospective cohort study from a UK primary care database.