Metabolic surgery, also known as bariatric or weight-loss surgery, has become an important treatment for people living with obesity and type 2 diabetes.
Although the operation is well known for helping people lose weight, researchers now understand that it also changes the way the body controls blood sugar.
For many patients, these changes can greatly improve diabetes and reduce the need for medication.
Type 2 diabetes is one of the leading causes of heart disease, stroke, kidney failure, blindness, and limb amputations.
People with diabetes are much more likely to develop serious cardiovascular problems than those without the condition. Finding treatments that lower these risks is therefore a major goal for doctors.
Previous studies have shown that around 60% to 80% of people who undergo metabolic surgery experience diabetes remission, meaning their blood sugar returns to normal without diabetes medicine.
However, scientists were unsure whether the surgery could still protect the heart if diabetes later returned or never completely disappeared.
New research presented at the 2023 annual meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS) provides encouraging answers. The findings suggest that metabolic surgery offers important heart benefits even for people whose diabetes is not fully cured.
The researchers analysed health records from 2016 to 2019. They compared 70,083 people with diabetes who had metabolic surgery with 348,212 similar patients who did not have the operation. The two groups were carefully matched for age, sex, race, and the severity of their diabetes so that the results would be as fair as possible.
People who had surgery experienced better overall health outcomes than those who did not. They were less likely to suffer major heart problems such as heart attacks and strokes. The risk of dying after a heart attack fell by more than 27%, while the risk of dying after a stroke was reduced by almost 27%.
Even when serious cardiovascular events occurred, patients who had undergone metabolic surgery were more likely to survive. According to Dr Jonathan Jenkins, better blood sugar control after surgery probably explains much of this protection, even when diabetes does not completely disappear.
The benefits extended beyond heart health. Patients who had surgery spent less time in hospital and had lower medical costs, saving between $1,000 and nearly $4,000. They were also less likely to require major procedures such as heart bypass surgery or limb amputation, two complications that can occur in advanced diabetes.
Dr Teresa LaMasters, President of ASMBS, said the findings show that metabolic surgery should not be judged only by whether diabetes goes into remission. Even without complete remission, the operation can reduce life-threatening complications and improve long-term health.
Metabolic surgery works in several ways. Besides helping people lose weight, it changes hormones released by the digestive system, improves the body’s response to insulin, and reduces inflammation. Together, these changes can improve blood sugar control and lower cardiovascular risk.
The researchers also noted that only about 1% of eligible people in the United States undergo metabolic surgery each year. Many patients may not realise how much the operation can improve long-term health when combined with healthy eating, regular physical activity, and ongoing medical care.
Although metabolic surgery is not suitable for everyone, this large study adds to growing evidence that it is much more than a weight-loss procedure. For carefully selected patients with obesity and type 2 diabetes, it may reduce the risk of heart disease, improve quality of life, and help people live longer.
If you care about diabetes, please read studies about 5 vitamins that may prevent complication in diabetes, and how to manage high blood pressure and diabetes with healthy foods.
For more health information, please see recent studies about vitamin D and type2 diabetes, and to people with type 2 diabetes, some fruits are better than others.
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