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The Effect of Bariatric Surgery on Diabetic Retinopathy: Good, Bad, or Both?

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Title: The Effect of Bariatric Surgery on Diabetic Retinopathy: Good, Bad, or Both?
Authors: Gorman, DM
Le Roux, CW
Docherty, NG
Item Type: Journal Article
Abstract: Bariatric surgery, initially intended as a weight-loss procedure, is superior to standard lifestyle intervention and pharmacological therapy for type 2 diabetes in obese individuals. Intensive medical management of hyperglycemia is associated with improved microvascular outcomes. Whether or not the reduction in hyperglycemia observed after bariatric surgery translates to improved microvascular outcomes is yet to be determined. There is substantial heterogeneity in the data relating to the impact of bariatric surgery on diabetic retinopathy (DR), the most common microvascular complication of diabetes. This review aims to collate the recent data on retinal outcomes after bariatric surgery. This comprehensive evaluation revealed that the majority of DR cases remain stable after surgery. However, risk of progression of pre-existing DR and the development of new DR is not eliminated by surgery. Instances of regression of DR are also noted. Potential risk factors for deterioration include severity of DR at the time of surgery and the magnitude of glycated hemoglobin reduction. Concerns also exist over the detrimental effects of postprandial hypoglycemia after surgery. In vivo studies evaluating the chronology of DR development and the impact of bariatric surgery could provide clarity on the situation. For now, however, the effect of bariatric surgery on DR remains inconclusive.
Issue Date: 27-Sep-2016
Date of Acceptance: 1-Aug-2016
URI: http://hdl.handle.net/10044/1/42058
DOI: http://dx.doi.org/10.4093/dmj.2016.40.5.354
ISSN: 2233-6087
Publisher: Korean Diabetes Association
Start Page: 354
End Page: 364
Journal / Book Title: Diabetes and Metabolism Journal
Volume: 40
Issue: 5
Copyright Statement: This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: ONO Pharmaceuticals Co Ltd
Funder's Grant Number: N/A
Keywords: Bariatric surgery
Diabetes mellitus
Diabetic retinopathy
Microvascular complications
Obesity
Publication Status: Published
Appears in Collections:Department of Medicine (up to 2019)