Bariatric surgery in individuals with type 2 diabetes is not associated with short or long-term risk of diabetic retinopathy progression: results from a nationwide cohort study.

Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9200299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5233 (Electronic) Linking ISSN: 09405429 NLM ISO Abbreviation: Acta Diabetol Subsets: MEDLINE

Publication: Berlin : Springer Verlag
Original Publication: Berlin : Springer International, c1991-

Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/surgery ; Diabetic Retinopathy*/epidemiology ; Diabetic Retinopathy*/etiology ; Bariatric Surgery*/adverse effects; Humans ; Female ; Middle Aged ; Male ; Cohort Studies ; Glycated Hemoglobin ; Risk Factors

Aims: Bariatric surgery is used to induce weight loss and glycemic stability in type 2 diabetes (T2D). It has been a concern that this may lead to early worsening of diabetic retinopathy (DR) due to a rapid decline in HbA1c. In this study, we evaluated the risk of short and long-term DR development and need for ocular intervention in an entire nation of individuals with T2D undergoing bariatric surgery.
Methods: The study comprised a national, register-based cohort of individuals with T2D screened for DR. Cases were matched by age, sex and DR level at the date of surgery (index date) with non-bariatric controls. We extracted information on DR levels, in- and outpatient treatments, pharmaceutical prescriptions and laboratory values. We evaluated worsening of DR (incident and progressive DR) at follow-up (6 and 36 months).
Results: Amongst 238,967 individuals with T2D, who attended diabetic eye screening, we identified 553 that underwent bariatric surgery (0.2%) and 2677 non-bariatric controls. Median age was 49 years, and 63% were female. Cases had more comorbidities, lower HbA1c as well as more frequent use of glucose-lowering and antihypertensive medication than controls at index date. In a fully adjusted logistic regression model, the risk of DR worsening for cases was not significantly different compared to controls, neither short-term (OR 0.41 [CI 95% 0.13; 1.33], p = 0.14) nor long-term (OR 0.64 [CI 95% 0.33; 1.24], p = 0.18).
Conclusions: In this nationwide study, bariatric surgery did not associate with increased risk of short- or long-term DR worsening.
(© 2023. The Author(s).)

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00028744 Velux Fonden

Keywords: Bariatric surgery; Diabetes; Diabetic retinopathy; Epidemiology; Nationwide

0 (Glycated Hemoglobin)

Date Created: 20230708 Date Completed: 20230927 Latest Revision: 20240402

20240403

PMC10520211

10.1007/s00592-023-02140-w

37421439