Microvascular complications of diabetes include diabetic nephropathy, neuropathy, and retinopathy, which affect the kidneys, nerves, and eyes, respectively. These diabetes-related complications are responsible for the high healthcare costs of type 2 diabetes and the leading causes for dialysis, amputations, and blindness in the Western world.
The risk of developing microvascular diabetic complications was 4-fold reduced in patients with type 2 diabetes undergoing surgery compared with patients with current guideline-based medical therapy. The analysis also found that pre-existing diabetic nephropathy was strongly improved by surgery compared with medical treatment. The likelihood for improvement or remission in patients with diabetes-related kidney damage was 15-times higher after surgery compared with current medical therapy.
“Medical therapy for type 2 diabetes seems to have reached its limitations, even with the newly available drugs. Metabolic surgery strongly reduces the risk for diabetes-associated complications and seems even to improve existing diabetic kidney damage in 1 out of 2 operated patients,” said lead author Dr. Adrian Billeter, of the University of Heidelberg, in Germany. “Such strong and reliable effects, especially on very difficult-to-treat diabetic kidney damage, are not even remotely possible with the current medical therapy,” added senior author Prof. Beat Müller-Stich, also of the University of Heidelberg.
Full bibliographic information:
Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus. British Journal of Surgery