Abstract
BackgroundComparative international practice of patients undergoing bariatric-metabolic surgery for type 2 diabetes mellitus (T2DM) is unknown. We aimed to ascertain baseline age, sex, body mass index (BMI) and types of operations performed for patients with T2DM submitted to the IFSO Global Registry.Materials and MethodsCross-sectional analysis of patients having primary surgery in 2015–2018 for countries with ≥90% T2DM data completion and ≥ 1000 submitted records.ResultsFifteen countries including 11 national registries met the inclusion criteria. The rate of T2DM was 24.2% (99,537 of 411,581 patients, country range 12.0–55.1%) and 77.1% of all patients were women. In every country, patients with T2DM were older than those without T2DM (overall mean age 49.2 [SD 11.4] years vs 41.8 [11.9] years, all p < 0.001). Men were more likely to have T2DM than women, odds ratio (OR) 1.68 (95% CI 1.65–1.71), p < 0.001. Men showed higher rates of T2DM for BMI <35 kg/m2 compared to BMI ≥35.0 kg/m2, OR 2.76 (2.52–3.03), p < 0.001. This was not seen in women, OR 0.78 (0.73–0.83), p < 0.001. Sleeve gastrectomy was the commonest operation overall, but less frequent for patients with T2DM, patients with T2DM 54.9% vs without T2DM 65.8%, OR 0.63 (0.63–0.64), p < 0.001. Twelve out of 15 countries had higher proportions of gastric bypass compared to non-bypass operations for T2DM, OR 1.70 (1.67–1.72), p < 0.001.ConclusionPatients with T2DM had different characteristics to those without T2DM. Older men were more likely to have T2DM, with higher rates of BMI <35 kg/m2 and increased likelihood of food rerouting operations.
Highlights
Over the last decade, randomised controlled trials (RCTs) [1,2,3,4,5], systematic reviews, meta-analyses [6, 7] and international guidelines [8,9,10,11] have indicated the benefits of bariatric-metabolic surgery for patients with type 2 diabetes mellitus (T2DM) and severe obesity compared to medical therapy alone
This study aimed to describe the differences in demographic data and type of bariatric and metabolic surgery performed in patients with and without T2DM according to the International Federation of Surgery for Obesity (IFSO) Global Registry 2015–2018
Sex, body mass index (BMI), relative proportions of operations per obesity class, and the operations undertaken for patients with T2DM compared to those without T2DM having primary bariatric-metabolic surgery in 15 countries in the IFSO Global Registry
Summary
Over the last decade, randomised controlled trials (RCTs) [1,2,3,4,5], systematic reviews, meta-analyses [6, 7] and international guidelines [8,9,10,11] have indicated the benefits of bariatric-metabolic surgery for patients with type 2 diabetes mellitus (T2DM) and severe obesity compared to medical therapy alone. The term metabolic surgery has been defined as ‘the operative manipulation of a normal organ or organ system to achieve a biological result for a potential health gain’, and has come to embrace any intervention of the gastrointestinal tract that improves T2DM, regardless of baseline body mass index (BMI) [13], while bariatric surgery, from the Greek ‘baros’ weight or pressure, and ‘-iatric’, the medicine or surgery thereof, has weight loss and its associated benefit as the primary endpoint. Comparative international practice of patients undergoing bariatric-metabolic surgery for type 2 diabetes mellitus (T2DM) is unknown. Materials and Methods Cross-sectional analysis of patients having primary surgery in 2015–2018 for countries with ≥90% T2DM data completion and ≥ 1000 submitted records
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