Health outcomes of patients with type 2 diabetes following bariatric surgery: Results from a publicly funded initiative

PLoS One. 2023 Feb 24;18(2):e0279923. doi: 10.1371/journal.pone.0279923. eCollection 2023.

Abstract

Objective: Bariatric surgery is an effective treatment for type 2 diabetes and morbid obesity. This paper analyses the clinical and patient-reported outcomes of patients treated through the Bariatric Surgery Initiative, a health system collaboration providing bariatric surgery as a state-wide public service in Queensland, Australia.

Research design and methods: A longitudinal prospective cohort study was undertaken. Eligible patients had type 2 diabetes and morbid obesity (BMI ≥ 35 kg/m2). Following referral by specialist outpatient clinics, 212 patients underwent Roux-en-Y gastric bypass or sleeve gastrectomy. Outcomes were tracked for a follow-up of 12-months and included body weight, BMI, HbA1c, comorbidities, health-related quality of life, eating behaviour, and patient satisfaction.

Results: Following surgery, patients' average body weight decreased by 23.6%. Average HbA1c improved by 24.4% and 48.8% of patients were able to discontinue diabetes-related treatment. The incidence of hypertension, non-alcoholic steatohepatitis, and renal impairment decreased by 37.1%, 66.4%, and 62.3%, respectively. Patients' emotional eating scores, uncontrolled eating and cognitive restraint improved by 32.5%, 20.7%, and 6.9%, respectively. Quality of life increased by 18.8% and patients' overall satisfaction with the treatment remained above 97.5% throughout the recovery period.

Conclusions: This study confirmed previous work demonstrating the efficacy of publicly funded bariatric surgery in treating obesity, type 2 diabetes and related comorbidities, and improving patients' quality of life and eating behaviour. Despite the short follow-up period, the results bode well for future weight maintenance in this cohort.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bariatric Surgery* / methods
  • Diabetes Mellitus, Type 2* / surgery
  • Gastrectomy / methods
  • Gastric Bypass* / methods
  • Glycated Hemoglobin
  • Humans
  • Laparoscopy* / methods
  • Obesity, Morbid* / surgery
  • Prospective Studies
  • Quality of Life
  • Treatment Outcome

Substances

  • Glycated Hemoglobin

Grants and funding

This study was funded by Queensland Health. Paul Scuffham was contracted by Queensland Health to undertake the evaluation. Paul Scuffham is also the recipient of a National Health and Medical Research Council Fellowship (#1136923).