Table 3.
Reported effects of bariatric surgery on the occurrence of chronic diabetes complications and impact on quality of life.
| Study | Follow up | Diabetes Complications | Quality of Life * |
|---|---|---|---|
| Dixon et al. (2002) [44] | 1 year | (Beck’s depression inventory, SF-36) Significant improvements in depression Significant improvement on physical health subscales |
|
| Schauer et al. (2003) [46] | 20 months (median) | 50% (self-reported) improvement in diabetic neuropathy symptoms | |
| Schauer et al. (2000) [105] | 16.9 months (mean) |
(Moorehead-Ardelt QOL Questionnaire) Quality of life 58% greatly improved, 37% improved, 5% no change | |
| Iaconelli et al. (2011) [49] | 10 years | All cases with microalbuminuria at baseline regressed by year 10. 2 new cases. Prevalence increased in the control group; 39.2% vs. 9% new nephropathy cases 4 major CV events vs. none |
|
| Schauer et al. (2012) (STAMPEDE) [51] | 5 years | No effect on ophthalmologic outcomes vs. conservative treatment Significantly lower albumin-to-creatinine ratio from baseline in the SG group vs. conservative No change in albuminuria status in any group |
(SF-36) Significant improvements in both surgical groups in the physical functioning, general health, and energy–fatigue subscales. Emotional well-being worsened significantly among patients in the gastric bypass group |
| Mingrone et al. (2012) [73] | 5 years | 5 major diabetic complications in the medically treated group (including 1 fatal myocardial infarction) vs. one in the RYGB arms | (SF-36) Better scores in physical and emotional aspects of QOL in both surgical arms compared to the medically treated arm |
| Carlsson et al. (2012) (SOS cohort) [53] | 18 years | Reduced rates of chronic diabetes complications in the surgical vs. control groups (HRs 0.44 and 0.65 for incident microvascular and macrovascular complications, respectively) | |
| Karlsson et al. (2007) (SOS cohort) [104] | 10 years | (SOS quality of life survey) at 0.5, 1, 2, 3, 4, 6, 8 and 10 years. Substantial early gain trends in QOL that parallel weight loss. Net gains at 10 years in all QOL domains. Greater improvements in social interaction in surgical than conventional arm at 10 years. Better overall mood scores in surgical group up to 2 years post op. Significantly better depression outcomes in surgical group vs. conventional at 10 years. Non-significant improvement in anxiety scores by year 10. |
|
| Adams et al. (2012) [54] | 6 years | (SF-36) Marked improvement in physical QOL components compared to controls. No significant changes in mental QOL components |
|
| Halperin et al. (2014) [61] | 1 year | (SF-36, PAID, EQ-5D, IWQOL) No significant differences between RYGB and intensive lifestyle management in components of SF36, PAID, EQ-5D. Greater improvement in IWQOL in RYGB correlated with BMI change |
|
| Risstad et al. (2015) [62] | 5 years | (SF-36) Similar improvements for RYGB and BPD in components of the SF36 and Obesity–related Problems Scale |
|
| Cummings et al. (2016) (CROSSROADS) [64] | 1 year | (EQ-5D) Similarly significant QOL improvements for RYGB and ILMI |
|
| Salminen et al. (2018) (SLEEVEPASS) [66] | 5 years | (Moorehead-Ardelt QOL questionnaire) Similar improvements regarding QOL in VSG and RYGB |
|
| Madesin et al. (2019) [67] | 5 years | 47% lower risk of microvascular complications in RYBG vs. controls Statistically non-significant 24% reduction in macrovascular complications in RYGB vs. controls |
* Text in parentheses indicate the quality of life assessment instrument used. QOL: quality of life; BMI: body mass index; BPD: biliopancreatic diversion; RYGB: Roux-en-Y gastric bypass; SG: sleeve gastrectomy; SOS: Swedish Obese Subjects; SF-36: Short Form (36) Health Survey; PAID: Problem Areas In Diabetes scale; EQ-5D: EuroQol-5D instrument; IWQOL: Impact of Weight on Quality of Life questionnaire.