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减重手术后 2 型糖尿病缓解及其对医疗保健费用的影响。

Type 2 Diabetes Remission After Bariatric Surgery and Its Impact on Healthcare Costs.

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA.

Global Health Economics and Outcomes Research, Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086, USA.

出版信息

Obes Surg. 2023 Dec;33(12):3806-3813. doi: 10.1007/s11695-023-06856-0. Epub 2023 Oct 18.

Abstract

PURPOSE

Bariatric surgery is the most effective and durable treatment of obesity and can put type 2 diabetes (T2D) into remission. We aimed to examine remission rates after bariatric surgery and the impacts of post-surgical healthcare costs.

MATERIALS AND METHODS

Obese adults with T2D were identified in Merative™ (US employer-based retrospective claims database). Individuals who had bariatric surgery were matched 1:1 with those who did not with baseline demographic and health characteristics. Rates of remission and total healthcare costs were compared at 6-12 and 6-36 months after the index date.

RESULTS

Remission rates varied substantially by baseline T2D complexity; differences in rates at 1 year ranged from 41% for those with high-complexity T2D to 66% for those with low- to mid-complexity T2D. At 3 years, those who had bariatric surgery had 56% higher remission rates than those who did not have bariatric surgery, with differences of 73%, 59%, and 35% for those with low-, mid-, and high-complexity T2D at baseline. Healthcare costs were $3401 and $20,378 lower among those who had bariatric surgery in the 6 to 12 months and 6 to 36 months after the index date, respectively, than their matched controls. The biggest cost differences were seen among those with high-complexity T2D; those who had bariatric surgery had $26,879 lower healthcare costs in the 6 to 36 months after the index date than those who did not.

CONCLUSION

Individuals with T2D undergoing bariatric surgery have substantially higher rates of T2D remission and lower healthcare costs.

摘要

目的

减重手术是治疗肥胖症最有效且持久的方法,可使 2 型糖尿病(T2D)得到缓解。本研究旨在评估减重手术后的缓解率以及对术后医疗成本的影响。

材料和方法

在 Merative (美国雇主基础回顾性索赔数据库)中确定患有 T2D 的肥胖成年人。将接受减重手术的个体与未接受减重手术的个体按基线人口统计学和健康特征进行 1:1 匹配。在指数日期后 6-12 个月和 6-36 个月时比较缓解率和总医疗成本。

结果

缓解率因基线 T2D 复杂性而异,差异在 1 年内的范围从高复杂性 T2D 患者的 41%到低至中复杂性 T2D 患者的 66%。在 3 年内,接受减重手术的患者缓解率比未接受减重手术的患者高 56%,在基线时低、中、高复杂性 T2D 的患者分别为 73%、59%和 35%。在指数日期后 6-12 个月和 6-36 个月时,接受减重手术的患者医疗成本分别比匹配的对照组低 3401 美元和 20378 美元。在高复杂性 T2D 患者中,成本差异最大;在指数日期后 6-36 个月,接受减重手术的患者医疗成本比未接受减重手术的患者低 26879 美元。

结论

患有 T2D 的患者接受减重手术后,T2D 的缓解率显著提高,医疗成本降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/10687155/73bd0507ccbd/11695_2023_6856_Fig1_HTML.jpg

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