title: Clinical Outcomes of Metabolic Surgery: Microvascular and Macrovascular Complications.
abstract: Understanding of the long-term clinical outcomes associated with bariatric surgery has recently been advanced. Research related to the sequelae of diabetes-in particular, long-term microvascular and macrovascular complications-in patients who undergo weight-loss surgery is imperative to this pursuit. While numerous randomized control trials have assessed glucose control with bariatric surgery compared with intensive medical therapy, bariatric surgery outcome data relating to microvascular and macrovascular complications have been limited to observational studies and nonrandomized clinical trials. As a result, whether bariatric surgery is associated with a long-term reduction in microvascular and macrovascular complications when compared with current intensive glycemic control therapy cannot be determined because the evidence is insufficient. However, the consistent salutary effects of bariatric surgery on diabetes remission and glycemic improvement support the opportunity (and need) to conduct high-quality studies of bariatric surgery versus intensive glucose control. This review provides relevant background information related to the treatment of diabetes, hyperglycemia, and long-term complications; reports clinical findings (to date) with bariatric surgery; and identifies ongoing research focusing on long-term vascular outcomes associated with bariatric surgery.
authors.affiliation: Intermountain LiVe Well Center, Intermountain Healthcare, and Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT ted.adams@imail.org.
authors.forename: Ted D
authors.initials: TD
authors.lastname: Adams
authors.affiliation: Group Health Research Institute, Seattle, WA.
authors.forename: David E
authors.initials: DE
authors.lastname: Arterburn
authors.affiliation: Diabetes Center, Massachusetts General Hospital, and Harvard Medical School, Boston, MA.
authors.forename: David M
authors.initials: DM
authors.lastname: Nathan
authors.affiliation: Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Eckel
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects*; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose