371-OR: Mortality in the Swedish Obese Subjects Study over up to 30 Years in Relation to Two-Year Diabetes Remission after Bariatric Surgery or Usual Care

Abstract

Introduction: Patients with obesity and concomitant type 2 diabetes (T2D) have reduced life expectancy, which may to some extent be explained by an increased risk of developing vascular diseases and cancer. Remission of T2D is known to reduce the risk of diabetes-related diseases. Here, we examined whether 2-year diabetes remission after bariatric surgery or usual care is associated with long-term mortality in patients from the Swedish Obese Subjects (SOS) study. Methods: This report includes 586 patients with obesity and baseline T2D; 338 underwent bariatric surgery and 248 obtained usual obesity care, median follow up was 26 years. The Swedish Cause of Death Register, case sheets and autopsy reports were assessed to determine the direct cause of death. Analyses were adjusted for preselected risk factors (age, sex, BMI and smoking at baseline, and year of inclusion in the study). Results: Overall, 284 patients were in remission at the 2-year examination whereas 302 were not. During follow-up, mortality rates were 16.6 deaths per 1000 person-years (95% CI:13.7-20.1) in the remission subgroup and 26.0 deaths per 1000 person-years (95% CI:22.2-30.4) in the non-remission subgroup (adjusted hazard ratio (AdjHR) 0.59, 95% CI:0.46-0.77, p<0.001). Specifically, cardiovascular mortality was decreased in the remission subgroup (Adj sub-HR 0.53, 95% CI:0.35-0.81, p=0.003). Moreover, 2-year remission was associated with reduced mortality after both surgery and usual care (AdjHR 0.57 (95% CI:0.39-0.83), p=0.003 and AdjHR 0.53 (95% CI:0.32-0.90), p=0.018, respectively). Conclusions: Remission of T2D after bariatric surgery or usual obesity care is associated with reduced long-term mortality, mainly due to decreased cardiovascular death. Disclosure K.Sjöholm: None. J.C.Andersson assarsson: None. M.Taube: None. L.Carlsson ekander: None. Funding Swedish Research Council; Swedish State; Swedish Heart and Lung Foundation; Swedish Diabetes Foundation; Adlerbert Research Foundation