Preventing Macrovascular Events With Bariatric Surgery

• Published in: JAMA : the journal of the American Medical Association Vol. 320; no. 15; pp. 1545 - 1547
• Main Authors: Sheka, Adam C, Wirth, Keith M, Ikramuddin, Sayeed
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 16-10-2018
• Subjects: Bariatric Surgery; Blood pressure; Body weight loss; Coronary artery; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Disease prevention; Gastrointestinal surgery; Humans; Incidence; Lipids; Medical treatment; Microvasculature; Obesity; Obesity, Morbid; Patients; Surgery; Weight loss
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.2018.14639

Obesity and type 2 diabetes are associated with an increased incidence of macrovascular disease events, including coronary artery and cerebrovascular disease. The mainstay for treating type 2 diabetes is lifestyle modification for weight loss and pharmaceutical control of lipids, blood pressure, and glucose. These treatments have largely been shown to reduce microvascular disease, with less effect on development of macrovascular disease. It has always been known that bariatric surgery improves microvascular disease. Another influential study, the Veterans Affairs Diabetes Trial, randomly assigned 1791 patients with diabetes to receive standard or intensive medical treatment. After 5 years, the standard treatment group had an HbAlc level of 8.4% compared with 6.9% in the intensively treated group. Fisher and colleagues present further evidence for the benefits of weight loss surgery in obese patients with diabetes by showing a significant reduction in the incidence of cardiovascular events when compared with controls.