Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus

Bariatric surgery is an emerging therapeutic approach for obese type 2 diabetes mellitus (T2DM) patients, with proven benefits for achieving target glucose control and even remission of diabetes. However, the effect of bariatric surgery upon diabetic retinopathy is still a subject of debate as some...

Descripción completa

Detalles Bibliográficos
Autores principales: Dascalu, Ana Maria, Stoian, Anca Pantea, Cherecheanu, Alina Popa, Serban, Dragos, Costea, Daniel Ovidiu, Tudosie, Mihail Silviu, Stana, Daniela, Tanasescu, Denisa, Sabau, Alexandru Dan, Gangura, Gabriel Andrei, Costea, Andreea Cristina, Nicolae, Vanessa Andrada, Smarandache, Catalin Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396947/
https://www.ncbi.nlm.nih.gov/pubmed/34442032
http://dx.doi.org/10.3390/jcm10163736
_version_ 1783744492414697472
author Dascalu, Ana Maria
Stoian, Anca Pantea
Cherecheanu, Alina Popa
Serban, Dragos
Costea, Daniel Ovidiu
Tudosie, Mihail Silviu
Stana, Daniela
Tanasescu, Denisa
Sabau, Alexandru Dan
Gangura, Gabriel Andrei
Costea, Andreea Cristina
Nicolae, Vanessa Andrada
Smarandache, Catalin Gabriel
author_facet Dascalu, Ana Maria
Stoian, Anca Pantea
Cherecheanu, Alina Popa
Serban, Dragos
Costea, Daniel Ovidiu
Tudosie, Mihail Silviu
Stana, Daniela
Tanasescu, Denisa
Sabau, Alexandru Dan
Gangura, Gabriel Andrei
Costea, Andreea Cristina
Nicolae, Vanessa Andrada
Smarandache, Catalin Gabriel
author_sort Dascalu, Ana Maria
collection PubMed
description Bariatric surgery is an emerging therapeutic approach for obese type 2 diabetes mellitus (T2DM) patients, with proven benefits for achieving target glucose control and even remission of diabetes. However, the effect of bariatric surgery upon diabetic retinopathy is still a subject of debate as some studies show a positive effect while others raise concerns about potential early worsening effects. We performed a systematic review, on PubMed, Science Direct, and Web of Science databases regarding the onset and progression of diabetic retinopathy in obese T2DM patients who underwent weight-loss surgical procedures. A total of 6375 T2DM patients were analyzed. Most cases remained stable after bariatric surgery (89.6%). New onset of diabetic retinopathy (DR) was documented in 290 out of 5972 patients (4.8%). In cases with DR at baseline, progression was documented in 50 out of 403 (12.4%) and regression in 90 (22.3%). Preoperative careful preparation of hemoglobin A1c (HbA1c), blood pressure, and lipidemia should be provided to minimize the expectation of DR worsening. Ophthalmologic follow-up should be continued regularly in the postoperative period even in the case of diabetic remission. Further randomized trials are needed to better understand the organ-specific risk factors for progression and provide personalized counseling for T2DM patients planned for bariatric surgery.
format Online
Article
Text
id pubmed-8396947
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-83969472021-08-28 Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus Dascalu, Ana Maria Stoian, Anca Pantea Cherecheanu, Alina Popa Serban, Dragos Costea, Daniel Ovidiu Tudosie, Mihail Silviu Stana, Daniela Tanasescu, Denisa Sabau, Alexandru Dan Gangura, Gabriel Andrei Costea, Andreea Cristina Nicolae, Vanessa Andrada Smarandache, Catalin Gabriel J Clin Med Review Bariatric surgery is an emerging therapeutic approach for obese type 2 diabetes mellitus (T2DM) patients, with proven benefits for achieving target glucose control and even remission of diabetes. However, the effect of bariatric surgery upon diabetic retinopathy is still a subject of debate as some studies show a positive effect while others raise concerns about potential early worsening effects. We performed a systematic review, on PubMed, Science Direct, and Web of Science databases regarding the onset and progression of diabetic retinopathy in obese T2DM patients who underwent weight-loss surgical procedures. A total of 6375 T2DM patients were analyzed. Most cases remained stable after bariatric surgery (89.6%). New onset of diabetic retinopathy (DR) was documented in 290 out of 5972 patients (4.8%). In cases with DR at baseline, progression was documented in 50 out of 403 (12.4%) and regression in 90 (22.3%). Preoperative careful preparation of hemoglobin A1c (HbA1c), blood pressure, and lipidemia should be provided to minimize the expectation of DR worsening. Ophthalmologic follow-up should be continued regularly in the postoperative period even in the case of diabetic remission. Further randomized trials are needed to better understand the organ-specific risk factors for progression and provide personalized counseling for T2DM patients planned for bariatric surgery. MDPI 2021-08-22 /pmc/articles/PMC8396947/ /pubmed/34442032 http://dx.doi.org/10.3390/jcm10163736 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Dascalu, Ana Maria
Stoian, Anca Pantea
Cherecheanu, Alina Popa
Serban, Dragos
Costea, Daniel Ovidiu
Tudosie, Mihail Silviu
Stana, Daniela
Tanasescu, Denisa
Sabau, Alexandru Dan
Gangura, Gabriel Andrei
Costea, Andreea Cristina
Nicolae, Vanessa Andrada
Smarandache, Catalin Gabriel
Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus
title Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus
title_full Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus
title_fullStr Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus
title_full_unstemmed Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus
title_short Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus
title_sort outcomes of diabetic retinopathy post-bariatric surgery in patients with type 2 diabetes mellitus
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396947/
https://www.ncbi.nlm.nih.gov/pubmed/34442032
http://dx.doi.org/10.3390/jcm10163736
work_keys_str_mv AT dascaluanamaria outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT stoianancapantea outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT cherecheanualinapopa outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT serbandragos outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT costeadanielovidiu outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT tudosiemihailsilviu outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT stanadaniela outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT tanasescudenisa outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT sabaualexandrudan outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT ganguragabrielandrei outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT costeaandreeacristina outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT nicolaevanessaandrada outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus
AT smarandachecatalingabriel outcomesofdiabeticretinopathypostbariatricsurgeryinpatientswithtype2diabetesmellitus