The effect of surgical weight loss on diabetes complications in individuals with class II/III obesity
Authors' conclusion
Bariatric surgery may be an effective approach to reverse PN in individuals with obesity. The observed stability of CAN and retinopathy may be an improvement compared with the natural progression of these conditions; however, controlled trials are needed.
Study context
- Population
- Individuals with class II/III obesity (BMI > 35 kg/m²) undergoing bariatric surgery; age 46.0 ± 11.3 years, 73.4% female79 completed follow-up
- Participants
- 127 individuals
- Exposure
- Before vs 2 years after bariatric surgery
- Bariatric surgeryn = 127
- Outcome
- PN: change in IENFD (fibres/mm) at distal leg and proximal thigh; CAN: change in E/I ratio; retinopathy: change in mean deviation on frequency doubling technology testing
- Follow-up
- 2 years following surgery
Main finding
As reported in the abstract
Intra-epidermal nerve fibre density (IENFD) proximal thigh (peripheral neuropathy (PN)) improved
+3.4 ± 7.8
p<0.01
Cardiovascular autonomic neuropathy (CAN) (E/I ratio) stable
−0.01 ± 0.1
p=0.89
Retinopathy (mean deviation) stable
−0.2 ± 3.0
p=0.52
Observational data: associations, not effects.
Further findings
Weight loss · 2 years following surgery
- Mean weight lost by participants
- 31.0 kg (SD 18.4)
- All metabolic risk factors improved except BP and total cholesterol
Fasting glucose reduction and retinopathy (linear regression)
- Greater reduction in fasting glucose associated with improvement in retinopathy (mean deviation point estimate)
- −0.7 (95% CI −1.3, −0.1)
Original publication
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