Evidence map›Paper›PMID 30083761›Full record

Observational studyAnnals of internal medicine2018

Microvascular Outcomes in Patients With Diabetes After Bariatric Surgery Versus Usual Care: A Matched Cohort Study.

Rebecca O'Brien, Eric Johnson, Sebastien Haneuse, Karen J Coleman, Patrick J O'Connor, David P Fisher, Stephen Sidney, Andy Bogart, Mary Kay Theis, Jane Anau and 2 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04626323 (Open, Randomized, Unicenter Study Comparing Metabolic Surgery With Intensive Medical Therapy to Treat Diabetic Kidney Disease), which is not on this map. Cited by 72 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 5 pooled it
–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.

NCT04626323 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

Open, Randomized, Unicenter Study Comparing Metabolic Surgery With Intensive Medical Therapy to Treat Diabetic Kidney Disease

TypeinterventionalSponsorHospital Alemão Oswaldo CruzRan2021 to 2024Enrolled60ConditionsDiabetes Mellitus, Type 2, Kidney Disease, Chronic, Kidney InjuryArmsRoux-en-Y gastric bypass, Best medical treatment
3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  2. Pooled it
  3. Management of obesity in kidney transplant candidates and recipients: A clinical practice guideline by the DESCARTES Working Group of ERA.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021
    Guideline
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Review
  9. Article
  10. Observational
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Obesity and Metabolic Health in CKD.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Review
  19. Article
  20. Review

12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Rebecca O'BrienThe Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California (R.O., D.P.F., S.S.).
Eric JohnsonKaiser Permanente Washington Health Research Institute, Seattle, Washington (E.J., M.K.T., J.A., D.A.).
Sebastien HaneuseHarvard T.H. Chan School of Public Health, Boston, Massachusetts (S.H.).
Karen J ColemanKaiser Permanente Southern California, Pasadena, California (K.J.C.).
Patrick J O'ConnorHealthPartners Institute, HealthPartners, Minneapolis, Minnesota (P.J.O.).
David P FisherThe Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California (R.O., D.P.F., S.S.).
Stephen SidneyThe Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California (R.O., D.P.F., S.S.).
Andy BogartKaiser Permanente Northern California, Oakland, California; RAND Corporation, Santa Monica, California (A.B.).
Mary Kay TheisKaiser Permanente Washington Health Research Institute, Seattle, Washington (E.J., M.K.T., J.A., D.A.).
Jane AnauKaiser Permanente Washington Health Research Institute, Seattle, Washington (E.J., M.K.T., J.A., D.A.).
Emily B SchroederInstitute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (E.B.S.).
David ArterburnKaiser Permanente Washington Health Research Institute, Seattle, Washington (E.J., M.K.T., J.A., D.A.).

Funding

Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI Alyce Sophia Adams, HILARY Kessler SELIGMAN · 2011 to 2026
$9.2M
Long-term Benefits and Risks of Bariatric Surgery in Integrated Care SystemsR01DK105960 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI ARTERBURN, DAVID ERIC, COLEMAN, KAREN JACQUELINE · 2015 to 2018
$2.7M
Impact of Bariatric Surgery on Long-term Diabetes Remission and ComplicationsR01DK092317 · NIDDK · KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · PI ARTERBURN, DAVID ERIC · 2012 to 2015
$2.3M
Blood Pressure and Progression of Diabetic Kidney DiseaseK23DK099237 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI SCHROEDER, EMILY BARTLETT · 2014 to 2018
$869k
NIDDK NIH HHS K23 DK099237NIDDK NIH HHS P30 DK092924NIDDK NIH HHS R01 DK092317NIDDK NIH HHS R01 DK105960
6 · The paper itself

Abstract

Background: Bariatric surgery improves glycemic control in patients with type 2 diabetes mellitus (T2DM), but less is known about microvascular outcomes. Objective: To investigate the relationship between bariatric surgery and incident microvascular complications of T2DM. Design: Retrospective matched cohort study from 2005 to 2011 with follow-up through September 2015. Setting: 4 integrated health systems in the United States. Participants: Patients aged 19 to 79 years with T2DM who had bariatric surgery (n = 4024) were matched on age, sex, body mass index, hemoglobin A1c level, insulin use, diabetes duration, and intensity of health care use up to 3 nonsurgical participants (n = 11 059). Intervention: Bariatric procedures (76% gastric bypass, 17% sleeve gastrectomy, and 7% adjustable gastric banding) compared with usual care. Measurements: Adjusted Cox regression analysis investigated time to incident microvascular disease, defined as first occurrence of diabetic retinopathy, neuropathy, or nephropathy. Results: Median follow-up was 4.3 years for both surgical and nonsurgical patients. Bariatric surgery was associated with significantly lower risk for incident microvascular disease at 5 years (16.9% for surgical vs. 34.7% for nonsurgical patients; adjusted hazard ratio [HR], 0.41 [95% CI, 0.34 to 0.48]). Bariatric surgery was associated with lower cumulative incidence at 5 years of diabetic neuropathy (7.2% for surgical vs. 21.4% for nonsurgical patients; HR, 0.37 [CI, 0.30 to 0.47]), nephropathy (4.9% for surgical vs. 10.0% for nonsurgical patients; HR, 0.41 [CI, 0.29 to 0.58]), and retinopathy (7.2% for surgical vs. 11.2% for nonsurgical patients; HR, 0.55 [CI, 0.42 to 0.73]). Limitation: Electronic health record databases could misclassify microvascular disease status for some patients. Conclusion: In this large, multicenter study of adults with T2DM, bariatric surgery was associated with lower overall incidence of microvascular disease (including lower risk for neuropathy, nephropathy, and retinopathy) than usual care. Primary Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases.

Indexed as

Bariatric SurgeryAdultAgedDiabetes Mellitus, Type 2Diabetic AngiopathiesDiabetic NephropathiesDiabetic NeuropathiesDiabetic RetinopathyFemaleFollow-Up StudiesHumansIncidenceMaleMicrocirculationMiddle AgedObesity, Morbid

Identifiers

PMID30083761
PMCPMC6759803

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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 OpenQuestion graph.