ArticleThe British journal of surgery2024
Cardiovascular and diabetes outcomes among patients with obesity and type 2 diabetes after metabolic bariatric surgery or glucagon-like peptide 1 receptor agonist treatment.
Article in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Limited Comparative Evidence Between Metabolic Bariatric Surgery and Incretin-Based Pharmacotherapy for Weight Loss in Type 2 Diabetes: A Systematic Review and Meta-Analysis.Journal of diabetes · 2026Pooled it
- Glucagon-Like Peptide-1 Receptor Agonists vs. Bariatric Endoscopy: A Systematic Review and Meta Analysis of Efficacy, Safety, and Metabolic Outcomes.Obesity surgery · 2026Pooled it
- Metabolic Bariatric Surgery versus GLP-1 Receptor Agonists for Obesity Management: A Systematic Review and Meta-Analysis.Obesity surgery · 2026Pooled it
- Pooled it
- Comparative Outcomes of GLP-1 Therapy vs. Bariatric Surgery in Patients with Cirrhosis.Obesity surgery · 2026Article
- Weight loss and cardiovascular outcomes with incretin-based therapies after metabolic and bariatric surgery: a nationwide US cohort study.EClinicalMedicine · 2026Article
- Patient characteristics and perioperative outcomes in the Bypass Equipoise Sleeve Trial (BEST) compared to general metabolic bariatric practice in Sweden.The British journal of surgery · 2025Article
- Shifting obesity treatment paradigms: Trends of glucagon-like peptide-1 receptor agonists and bariatric surgery in the United States.Diabetes, obesity & metabolism · 2025Article
- Association of health literacy and general self-efficacy with emergency department visits for unclear abdominal pain after bariatric surgery.Langenbeck's archives of surgery · 2025Article
- Duodenal mucosal ablation with irreversible electroporation reduces liver lipids in rats with non-alcoholic fatty liver disease.World journal of gastroenterology · 2025Article
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Abstract
backgroundWith the increasing prevalence of obesity and type 2 diabetes, the availability of different treatment options remains essential. Studies comparing the outcomes of glucagon-like peptide 1 receptor agonists with those of metabolic bariatric surgery in patients with type 2 diabetes and obesity are lacking.
methodsUsing propensity score matching, based on data from several nationwide clinical registries, patients who underwent primary metabolic bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) were matched with patients who received glucagon-like peptide 1 receptor agonists. Outcome measures included the occurrence of major cardiovascular events, microvascular complications, and potential side effects (alcohol/substance abuse, self-harm, and fractures).
resultsOver a mean follow-up of 7 years, major cardiovascular events occurred in 191 of 2039 patients (cumulative incidence 14.5%) in the surgery group compared with 247 of 2039 patients (19.6%) in the glucagon-like peptide 1 receptor agonist group (HR 0.75 (95% c.i. 0.62 to 0.91), P = 0.003). Patients in the surgery group had lower haemoglobin A1c values 5 years after treatment (mean difference 9.82 (95% c.i. 8.51 to 11.14) mmol/mol, P < 0.001) and fewer microvascular complications (retinopathy HR 0.88 (95% c.i. 0.79 to 0.99), P = 0.039; nephropathy HR 0.72 (95% c.i. 0.66 to 0.80), P < 0.001; and neuropathy or leg ulcers HR 0.82 (95% c.i. 0.74 to 0.92), P < 0.001), but a higher risk of alcohol/substance abuse (HR 2.56 (95% c.i. 1.87 to 3.50), P < 0.001), self-harm (HR 1.41 (95% c.i. 1.17 to 1.71), P < 0.001), and fractures (HR 1.86 (95% c.i. 1.11 to 3.12), P = 0.019).
conclusionCompared with glucagon-like peptide 1 receptor agonist treatment, metabolic bariatric surgery is associated with superior metabolic outcomes and a lower risk of major cardiovascular events in patients with type 2 diabetes and obesity, but a higher risk of alcohol/substance abuse, self-harm, and fractures.
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