Hormonal
Metabolic and bariatric surgery (MBS) is associated with a significantly lower risk of major adverse cardiovascular events (MACE) and all-cause mortality compared to treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA) in patients with type-2 diabetes and severe obesity.
For patients with type-2 diabetes and severe obesity, metabolic surgery appears to offer better protection against major heart events and death than treatment with GLP-1 medications alone. While surgery carries a small risk of complications, the long-term cardiovascular benefits outweigh these risks compared to pharmacological management. Patients should discuss these specific cardiovascular outcomes with their healthcare providers when choosing between surgical and medical management.
In this matched cohort study, MBS was associated with lower risk for MACE compared to treatment with early GLP-1 RA in patients with T2D.
Why this rating
Large nationwide cohort study with propensity score matching, but non-randomized design limits causal inference.
Source
Major adverse cardiovascular events among patients with type-2 diabetes, a nationwide cohort study comparing primary metabolic and bariatric surgery to GLP-1 receptor agonist treatment
Erik Stenberg et al. · International Journal of Obesity · 2023
DOI 10.1038/s41366-023-01254-z
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