Observational studyBMJ open2019
Pros and cons of gastric bypass surgery in individuals with obesity and type 2 diabetes: nationwide, matched, observational cohort study.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Pooled it
- Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis.European heart journal · 2022Pooled it
- Impact of Bariatric Surgery in Reducing Macrovascular Complications in Severely Obese T2DM Patients.Obesity surgery · 2021Pooled it
- Effects of Bariatric Surgery on Cancer Risk: Evidence from Meta-analysis.Obesity surgery · 2020Pooled it
- Impact of Empagliflozin on mRNA Levels of Cardiotrophin-1 and GDF-15 in Patients with Type 2 Diabetes and ST-Segment Elevation Myocardial Infarction Undergoing PCI: A Double-Blind Pilot Trial.Journal of cardiovascular and thoracic research · 2026Article
- Mechanistic Insights into Antioxidant Interventions Targeting Obesity-Induced Oxidative Stress in the Pathogenesis and Complications of Type 2 Diabetes Mellitus.Current issues in molecular biology · 2025Review
- Long-term effects of gastric bypass and sleeve gastrectomy in type 2 diabetes: a matched retrospective cohort study from Sweden.The Lancet regional health. Europe · 2025Article
- Health and economic gains from bariatric surgery in Portugal: an in-depth analysis using a Markov model.Health economics review · 2025Article
- Metabolic surgery versus usual care effects on mortality among patients with obesity and type 2 diabetes: A systematic review and meta-analysis.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2025Review
- Bariatric surgery and all-cause mortality: A methodological review of studies using a non-surgical comparator.Diabetes, obesity & metabolism · 2024Review
- Comparing effects of obesity treatment with very low energy diet and bariatric surgery after 2 years: a prospective cohort study.BMJ open · 2022Observational
- Potential Effects of Bariatric Surgery on the Incidence of Heart Failure and Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus and Obesity and on Mortality in Patients With Preexisting Heart Failure: A Nationwide, Matched, Observational Cohort Study.Journal of the American Heart Association · 2021Observational
- Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Review
- Bariatric surgery to aLleviate OCcurrence of Atrial Fibrillation Hospitalization-BLOC-AF.Heart rhythm O2 · 2020Article
- Article
- Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?International journal of environmental research and public health · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLong-term effects of gastric bypass (GBP) surgery have been presented in observational and randomised studies, but there are only limited data for persons with obesity and type 2 diabetes mellitus (T2DM) regarding postoperative complications.
designThis is a nationwide observational study based on two quality registers in Sweden (National Diabetes Register, NDR and Scandinavian Obesity Surgery Register, SOReg) and other national databases.
settingAfter merging the data, we matched individuals with T2DM who had undergone GBP with those not surgically treated for obesity on propensity score, based on sex, age, body mass index (BMI) and calendar time. The risks of postoperative outcomes (rehospitalisations) were assessed using Cox regression models.
participantsWe identified 5321 patients with T2DM in the SOReg and 5321 matched controls in the NDR, aged 18-65 years, with BMI >27.5 kg/m² and followed for up to 9 years. PRIMARY AND SECONDARY OUTCOME MEASURES: We assessed risks for all-cause mortality and hospitalisations for cardiovascular disease, severe kidney disease, along with surgical and other medical conditions.
resultsThe results agree with the previously suggested lower risks of all-cause mortality (49%) and cardiovascular disease (34%), and we also found positive effects for severe kidney disease but significantly increased risks (twofold to ninefold) of several short-term complications after GBP, such as abdominal pain and gastrointestinal conditions, frequently requiring surgical procedures, apart from reconstructive plastic surgery. Long-term, the risk of anaemia was 92% higher, malnutrition developed approximately three times as often, psychiatric diagnoses were 33% more frequent and alcohol abuse was three times as great as in the control group.
conclusionsThis nationwide study confirms the benefits and describes the panorama of adverse events after bariatric surgery in persons with obesity and T2DM. Long-term postoperative monitoring and support, as better selection of patients by appropriate specialists in interdisciplinary settings, should be provided to optimise the outcomes.
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What OpenQuestion holds
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.