Bariatric Surgery and Prevention of Type 2 Diabetes in Swedish Obese Subjects

摘要: BACKGROUND Weight loss protects against type 2 diabetes but is hard to maintain with behavioral modification alone. In an analysis of data from a nonrandomized, prospective, controlled study, we examined the effects bariatric surgery on prevention diabetes. METHODS this analysis, included 1658 patients who underwent and 1771 obese matched controls (with matching performed group, rather than individual, level). None participants had at baseline. Patients in bariatric-surgery cohort banding (19%), vertical banded gastroplasty (69%), or gastric bypass (12%); matched, prospective received usual care. Participants were 37 60 years age, body-mass index (BMI; weight kilograms divided by square height meters) was 34 more men 38 women. This focused rate incident diabetes, which prespecified secondary end point main study. At time (January 1, 2012), been followed for up 15 years. Despite matching, some baseline characteristics differed significantly between groups; body higher risk factors pronounced group control group. years, 36.2% original dropped out 30.9% not yet reached their 15-year follow-up examination. RESULTS During period, developed 392 110 corresponding incidence rates 28.4 cases per 1000 person-years 6.8 person-years, respectively (adjusted hazard ratio surgery, 0.17; 95% confidence interval, 0.13 0.21; P<0.001). The effect influenced presence absence impaired fasting glucose (P = 0.002 interaction) BMI 0.54). Sensitivity analyses, including end-point imputations, did change overall conclusions. postoperative mortality 0.2%, 2.8% required reoperation within 90 days owing complications. CONCLUSIONS Bariatric appears be markedly efficient care persons. (Funded Swedish Research Council others; ClinicalTrials.gov number, NCT01479452.)