Evidence mapPaperPMID 40504938Full record

ArticleDiabetes care2025

Health Expenditures Decline After Bariatric Surgery for Patients With Type 2 Diabetes.

Caroline E Sloan, Lindsay Zepel, Valerie A Smith, David E Arterburn, Aileen Baecker, Amy G Clark, Aniket A Kawatkar, Ryan M Kane, Christopher R Daigle, Karen J Coleman and 1 more

Abstract read
In one paragraph

Article in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Caroline E SloanDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
Lindsay ZepelDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Valerie A SmithDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
David E ArterburnKaiser Permanente Washington Health Research Institute, Seattle, WA.
Aileen BaeckerDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Amy G ClarkDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Aniket A KawatkarDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Ryan M KaneDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
Christopher R DaigleKaiser Permanente Washington Health Research Institute, Seattle, WA.
Karen J ColemanDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Matthew L MaciejewskiDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.ORCID 0000-0003-1765-5938

Funding

Duke Clinical and Translational Science Institute n/aHSRD VA IK6 HX003157NIDDK NIH HHS R01 DK125380VA RCS 10-391
6 · The paper itself

Abstract

objectiveBariatric surgery lowers the risk of developing microvascular and macrovascular complications of type 2 diabetes, but it is unclear whether it also lowers long-term health expenditures in this population. RESEARCH DESIGN AND

methodsIn a retrospective cohort study of 6,690 patients with obesity and type 2 diabetes who underwent bariatric surgery in 2012-2019 and 19,122 matched nonsurgical patients, we compared total, outpatient, inpatient, and medication expenditures 3 years presurgery and 5.5 years postsurgery, using generalized estimating equations. Expenditures were estimated in 6-month intervals.

resultsSurgical and nonsurgical cohorts were well-matched, with 73% female, average BMI 44 kg/m2, mean age 50 years, and 32% on insulin. Estimated total expenditures were similar between surgical and nonsurgical patients up to 1 year presurgery. Total expenditures were significantly lower for surgical patients starting 1 year postsurgery and up to 5.5 years postsurgery compared with control patients ($566 lower per 6-month interval at 5.5 years; 95% CI -$807, -$316). Expenditure differences were largely attributable to a 56% drop in medication expenditures for surgical patients, from $2,204 in the 6 months presurgery to $969 per 6-month interval at 5.5 years postsurgery. Surgical patients had a higher probability of inpatient admission throughout the postsurgical period (4.0-6.5% vs. 2.4-3.1% per 6-month interval).

conclusionsPatients with type 2 diabetes undergoing bariatric surgery have significantly lower total postsurgical expenditures than matched control patients, primarily because of substantial reductions in pharmacy expenditures. The long-term cost savings associated with bariatric surgery are likely to increase further, given the rapidly escalating costs of diabetes pharmacotherapy.

Indexed as

Bariatric SurgeryDiabetes Mellitus, Type 2Health ExpendituresAdultFemaleHumansMaleMiddle AgedRetrospective Studies

Identifiers

PMID40504938
PMCPMC12368378

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.