Among adults with obesity, the risks for death from cardiovascular diseases, diabetes and respiratory conditions were lower among those with diabetes who underwent Roux-en-Y gastric bypass compared with those without diabetes who had the procedure and compared with those with diabetes who had no obesity surgery, according to study findings published in Diabetes Care.
Michelle R. Lent, PhD, of the Obesity Institute at Geisinger Clinic in Danville, Pennsylvania, and colleagues evaluated data on adults who underwent Roux-en-Y gastric bypass (RYGB; 625 with diabetes; 1,803 without) at a large comprehensive medical center between January 2004 and December 2015. Controls who did not undergo surgery were matched to participants with and without diabetes. The researchers sought to determine all-cause and specific-cause mortality after RYGB.
Postoperative median follow-up was 5.8 years for participants with diabetes and 6.7 years for participants without diabetes.
More deaths occurred in controls (n = 138) than the RYGB group (n = 91) through follow-up. The risk for all-cause mortality was significantly reduced in the RYGB group compared with controls (HR = 0.65; 95% CI, 0.5-0.84).
RYGB participants with diabetes — but not in RYGB participants without diabetes — experienced reduced mortality (HR = 0.42; 95% CI, 0.28-0.63). Results were similar after adjustment for matched variables, smoking and use of medications.
Mortality rates from CVD (P = .011), respiratory conditions (P = .017) and diabetes (P = .011) were lower in RYGB participants with diabetes than in controls with diabetes.
The risks for death from cancer (P = .0038) and respiratory conditions (P = .046) were lower, and the risk for death from external causes (P = .012) was higher among RYGB participants without diabetes compared with controls without diabetes.
“Though patients without diabetes did not experience changes in all-cause mortality risk after surgery, patients can still benefit from the other well-documented benefits of RYGB, including better quality of life,” the researchers wrote. “RYGB reduced mortality attributable to CVD, diabetes and respiratory conditions, but also elevated the risk of mortality from external causes. This study strengthens the available knowledge of the durable health benefits of bariatric surgery for patients with type 2 diabetes by associated remission to enhanced life expectancy.” – by Amber Cox
Disclosures: The researchers report no relevant financial disclosures.