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Bariatric surgery cuts long-term cardiovascular risk in diabetics

March 31, 2011 - Washington

A new study has shown that bariatric surgery reduces the risk of Heart attack and stroke in patients with Diabetes.

"This is a watershed moment for Diabetes care. With 20 years of data, we can really see how the surgery can improve a spectrum of health measures-notably cardiovascular risk," said Francesco Rubino, director of the Congress and director of gastrointestinal metabolic surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

While Type 2 Diabetes is not technically a cardiovascular disease, experts said it might as well be one, given the corrosive effects of unregulated blood sugar on the heart. According to the American Heart Association, at least 65 percent of people with diabetes die of some form of heart disease or stroke.

Lars Sjostrom, professor at the Institute of Medicine in Goteborg, Sweden, presented new data gleaned from the Swedish Obese Subjects (SOS) study. He reported on 20 years of data comparing 2,010 bariatric surgeries with 2,037 non-surgical patients who received medical treatment or lifestyle modification for Obesity.

"Type 2 Diabetes has always been considered a chronic, lifelong disease, but the long-term data show remission in 70 percent of patients after two years of follow-up," he said.

"Thirty percent are still in remission 15 years after bariatric surgery. Even more remarkable, 20 years out, we have seen that bariatric surgery has reduced new cases of Diabetes by 80 percent among obese patients who did not have the disease at the start of the study."

Sjostrom concluded that the surgery's preventive effect seems to be even stronger and more long-lasting than its ability to sustain long-term remission. Equally striking, the incidence of new cardiovascular events-either Heart attack or stroke-has been at least 30 percent lower among postsurgical patients than their conservatively treated counterparts.

A Utah-based study presented similar clinical outcomes. After Gastric bypass surgery, patients were seen to have greater reductions in Blood Pressure, heart rate, triglycerides, low-density lipoprotein (LDL) cholesterol, and insulin resistance than did patients in the group of severely obese patients who were treated via medication and lifestyle modification. The surgical group also experienced favorable changes in heart function and "geometry"-a subtle remodeling of the heart's components leading to greater efficiency.

The study's principal investigator, Ted Adams of the University of Utah School of Medicine, believes the new data support the use of bariatric surgery to prevent the cardiovascular complications associated with Obesity and Type 2 Diabetes.

The results were presented at the 2nd World Congress on Interventional Therapies for Type 2 Diabetes, hosted by NewYork-Presbyterian Hospital and Weill Cornell Medical College.


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