Microvascular complications of obesity and diabetes-Role of bariatric surgery
Bashir, B. Iqbal, Z. Adam, Safwaan Ferdousi, M. Chick, W. Hussein, H. A. Syed, A. A. Le Roux, C. W. Cohen, R. V. Malik, R. A.
Bashir, B.
Iqbal, Z.
Adam, Safwaan
Ferdousi, M.
Chick, W.
Hussein, H. A.
Syed, A. A.
Le Roux, C. W.
Cohen, R. V.
Malik, R. A.
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Abstract
Bariatric surgery in people with obesity can lead to long-term remission of type 2 diabetes mellitus (T2DM) and a reduction in the incidence of macrovascular complications. The impact of bariatric surgery on microvascular complications is less clear. In this narrative review, we sought to evaluate the effect of bariatric surgery on microvascular complications in patients with and without diabetes. The risk of developing microvascular complications is increased in people with obesity, and this is amplified in those with T2DM. The impact of metabolic surgery on microvascular complications is limited to a subgroup analysis of studies or statistical modeling to predict the glycemia-independent effect of bariatric surgery. While bariatric surgery halts the progression of retinopathy in those with minimal retinopathy, it may worsen in those with advanced retinopathy. Bariatric surgery improves proteinuria and major renal outcomes, regardless of the severity of renal impairment. Bariatric surgery in patients with obesity with or without diabetes is associated with an improvement in neuropathic symptoms and regeneration of small nerve fibers. In conclusion, bariatric surgery is associated with an improvement in microvascular complications. Further studies are needed to elucidate the underlying mechanisms for the favorable effect of bariatric surgery on microvascular outcomes.
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Date
2023
Publisher
Collections
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Type
Article
Citation
Bashir B, Iqbal Z, Adam S, Ferdousi M, Chick W, Hussein HA, et al. Microvascular complications of obesity and diabetes-Role of bariatric surgery. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2023 Jul 29:e13602. PubMed PMID: 37515402. Epub 2023/07/29. eng.