Evaluation of Current Eligibility Criteria for Bariatric Surgery
Diabetes prevention and risk factor changes in the Swedish Obese Subjects (SOS) study
Featured Article:
Kajsa Sjöholm, Ph.D., Åsa Anveden, M.D., Markku Peltonen, Ph.D., Peter Jacobson, M.D., Ph.D.,
Stefano Romeo, M.D., Ph.D., Per-Arne Svensson, Ph.D., Lars Sjöström, M.D., Ph.D., Lena M.S. Carlsson, M.D., Ph.D.
Diabetes Care Volume 36: 1335-1340
May, 2013
STUDY OBJECTIVE
• Patients with BMI <35 kg/m2 and patients with BMI of 35–40 kg/m2 without comorbidities are not eligible for bariatric surgery
• We used Swedish obese subjects to explore long-term outcomes in noneligible versus eligible patients
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340
STUDY DESIGN AND METHODS
• Study involved 2,010 obese patients who underwent bariatric surgery and 2,037 contemporaneously matched obese controls
• Age 37–60 years and BMI ≥34 kg/m2 in men and ≥38 kg/m2 in women
• Effect of surgery was assessed in patients who do (n = 3,814) and do not (n = 233) meet eligibility criteria
• Date of analysis 1 January 2012
• Follow-up time was up to 20 years, with a median of 10 years
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340
RESULTS
• Cardiovascular risk factors were significantly improved both in noneligible and eligible individuals after 10 years of follow-up
• Surgery reduced diabetes incidence in both noneligible and eligible groups
• No difference detected in the effect of surgery between the groups
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340
CONCLUSIONS
• Bariatric surgery drastically reduced the incidence of type 2 diabetes both in noneligible and eligible patients and improved cardiovascular risk factors in both groups
• Strict BMI cutoffs are of limited use for bariatric surgery prioritization if the aim is to prevent diabetes and improve cardiovascular risk factors
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340
Sjöholm K. et al. Diabetes Care 2013;36:1335-1340