ECE2020 Symposia Controversial issues in bariatric surgery (3 abstracts)
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Background: Over the last decade, bariatric and metabolic surgery has been recognized as an important step in the treatment algorithm for type-2 diabetes (T2DM). Despite early suggestions of surgery providing a potential cure for T2DM, only a small proportion of all patients who could benefit from surgery are ultimately considered for this treatment. Furthermore, the long-term effects on T2DM still remains somewhat controversial.
Methods and results: A review of the current literature as well as data from the Scandinavian Obesity Surgery Registry (SOReg) were considered. Remission of diabetes occurred for 58–89% of patients with T2DM. A higher chance of remission was reported for patients with shorter duration and a less severe disease. Age, surgical method, postoperative weight-loss, sex and socioeconomic status may also influence the chance of reaching remission. Relapse of disease was reported to occur in 19–50% of those who initially experienced remission. Longer duration and a more severe disease, as well as female sex, weight-regain, and type of surgery are associated with higher risk for relapse. Patients who eventually relapse still experience reduction in the risk for diabetes complications.
Conclusion: The chance of reaching diabetes remission after metabolic and bariatric surgery is high. While relapse is common, patients still experience long-term metabolic benefits from this type of surgery.