Medical events and costs associated with metabolic bariatric surgery among adults with type 2 diabetes: A retrospective, matched cohort study
Authors' conclusion
MBS was performed relatively infrequently in adults with T2D + O. Cases, compared with controls, used fewer GLM, had significantly lower post-period all-cause drug costs, and lower rates of incident comorbidities, but had significantly higher post-period all-cause total medical costs and higher rates of medical events.
Study context
- Population
- Adults with T2D and obesity, Optum Market Clarity US data, 2013–2022; mean age 52.9 years (SD 10.2), 69.2% femalematched cohort
- Participants
- 5,485 vs 5,485
- Exposure
- Metabolic/bariatric surgery (MBS) vs no MBS
- Casesn = 5,485
- Controlsn = 5,485reference
- Outcome
- Rate of MBS among adults with T2D + obesity
- Follow-up
- 2013 through 2022
Methodological detailsmatched 1:1 without replacement on demographics and baseline body mass index (BMI)
- Matched 1:1 without replacement on demographics and baseline BMI
Main finding
As reported in the abstract
Underwent MBS, all adults with T2D + obesity
0.5%
Underwent MBS, class 1 obesity
0.3%
Underwent MBS, class 2 obesity
0.5%
Underwent MBS, class 3 obesity
0.9%
Observational data: associations, not effects.
Further findings
Glucose-lowering medication (GLM) use, drug costs and incident comorbidities · 3-year post-period
- Cases used significantly fewer GLMs, had significantly lower all-cause drug costs and generally lower rates of incident comorbidities vs controls
All-cause acute care, outpatient and total costs · 3-year post-period
- MBS associated with significantly higher all-cause acute care, outpatient and total costs
Safety
Post-period medical events · 3-year post-period
- Vitamin D deficiency
- 56.8%
- Endoscopy
- 41.2%
- MBS generally associated with higher rates of post-period medical events
Original publication
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