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TUESDAY, Oct. 16, 2018 (HealthDay News) – A new large-scale study suggests that obesity surgery can help prevent heart attacks and strokes in people with excessive overweight and suffering from diabetes .
It is already known that obesity surgery can help people lose weight and better manage health problems such as diabetes and high blood pressure.
But it has not been clear if this would result in fewer heart attacks and strokes on the road.
The researchers said the new findings suggest the answer is "yes".
The study team found that severely obese patients undergoing surgery were 40% less likely to have a heart attack or stroke over a five-year period, compared to those receiving treatment. standard diabetes.
Individuals who have undergone surgery are also two-thirds less likely to die during the study period, according to the report released Oct. 16. Journal of the American Medical Association.
"If we had a pill that could do it, we would prescribe it all," said co-author of the study, Dr. David Arterburn.
For most people, medications, diet, and exercise are the cornerstones of managing type 2 diabetes. But for people with severe obesity, this might not be enough, said Arterburn, senior scientist at the Kaiser Permanente Washington Institute for Health Research, Seattle.
He added that he hoped the new findings would encourage more doctors and patients to consider surgery.
That said, the study was not a clinical trial that directly tested obesity surgery versus standard diabetes care. It was an "observational" study during which researchers compared the medical records of people who had undergone obesity surgery and similar patients who had had conventional care.
These types of studies do not prove the cause-and-effect relationship, explained Arterburn.
Nevertheless, the new findings offer the "best evidence available" that obesity surgery can ultimately prevent heart attacks and strokes, he said.
According to the US National Institutes of Health (NIH), obesity surgery may be an option for people with a body mass index (BMI) of 40 or more – about 100 pounds or more in overweight.
People with less severe obesity (a BMI of at least 35) may be candidates if they suffer from diseases such as diabetes or sleep apnea.
There are disadvantages to the treatment. According to the NIH, surgery costs an average of $ 15,000 to $ 25,000, depending on the type of procedure. There are surgical risks, including bleeding and infections. And in the long run, side effects include nutritional deficiencies, hernias and ulcers.
"This treatment is invasive," said Arterburn. "There are risks, and this requires lifestyle changes throughout life."
But, he added, these elements must be weighed against the potential benefits.
To study the longer term prospects, the Arterburn team reviewed the records of about 5,300 patients with type 2 diabetes who had undergone obesity surgery. They were compared to similar patients who were taking oral medications, and sometimes insulin, to manage their diabetes.
In the last five years, just over 4% of the group in the group on medication had a heart attack or stroke. This rate was cut in half, to about 2%, in the surgery group.
The researchers weighed other factors, including age, race and uncontrolled hypertension. And obesity surgery was always linked to a risk of cardiovascular complications reduced by 40%.
Patients who underwent surgery were also less likely to die during the study period: after five years, just over 1% had died, compared to 4.5% in the control group, according to the estimates. results.
Dr. Sayeed Ikramuddin is the chair of surgery at the University of Minnesota School of Medicine in Minneapolis.
He added that surgery can bring benefits to the "right person", which means that it is not for everyone who is suffering from severe obesity.
Some people may, for example, have health problems making the surgery difficult, explained Ikramuddin, who co-authored an editorial published with the study.
He pointed out the situation as a whole: weight loss is essential for people with severe obesity.
"Controlling your blood sugar will not necessarily take you where you need to be," said Ikramuddin. "There are benefits to losing a lot of weight – no matter the outcome."
He suggested that people talk to their doctor about all options for weight loss, including weight-loss medications associated with lifestyle changes.
"Surgery is an option in the spectrum," Ikramuddin said.
More information
The US National Institute of Diabetes and Digestive and Kidney Diseases has more to do with obesity surgery.
SOURCES: David Arterburn, M.D., M.P.H., Principal Investigator, Kaiser Permanente Institute for Health Research Washington, Seattle; Sayeed Ikramuddin, M.D., M.H.A., Director of the Department of Surgery, Faculty of Medicine, University of Minnesota, Minneapolis; October 16, 2018, Journal of the American Medical Association
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