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Drugs like semaglutide and liraglutide might assist to scale back the chance of coronary heart assaults, strokes, and different main adversarial cardiovascular occasions (MACE) in addition to loss of life in adults with weight problems and diabetes following bariatric surgical procedure who didn’t obtain enough weight reduction and diabetes management, in accordance with new analysis offered on the European Congress on Weight problems (ECO25) in Malaga, Spain (11–14 Might).
The observational, real-life retrospective cohort research discovered that in adults with weight problems and sort 2 diabetes however no prior coronary heart illness, glucagon-like peptide-1 receptor agonists (GLP-1RAs) helped to enhance weight-loss and diabetes management in sufferers that didn’t enhance sufficiently after surgical procedure.
Remedy with GLP-1RAs was related to a 67% decrease danger of MACE or loss of life from any trigger in comparison with those that had bariatric surgical procedure alone.
“These findings provide important initial clinical insights,” stated co-lead creator Professor Orna Reges from Ariel College and Clalit Well being Companies in Israel.
“In real-life settings, people living with obesity and type 2 diabetes are at increased risk of cardiovascular disease, and these results suggest that initiating GLP-1RAs after bariatric surgery may help to achieve sustained reductions in weight and blood glucose levels—comparable to those achieved by bariatric surgery alone in other patients—and may also reduce the long-term risk for MACE.”
GLP-1RAs, taken as soon as every week by injection, simulate naturally produced incretin hormones, which assist to decrease blood sugar ranges after a meal, and in addition sluggish digestion, so folks really feel full for longer, inflicting them to eat much less.
In folks with weight problems and sort 2 diabetes, the separate benefit of bariatric surgical procedure and GLP-1RAs in decreasing weight, glucose stage, and MACE is nicely established. Nevertheless, the advantage of GLP-1RA remedy after bariatric surgical procedure for the first prevention of MACE is unclear.
To handle this hole, researchers analyzed digital well being document information for sufferers (aged 24 years or older) with weight problems (BMI of 30 kg/m2 or larger) and sort 2 diabetes who underwent bariatric surgical procedure alone or have been handled with GLP-1RAs (semaglutide [76%] and liraglutide [13%]) following bariatric surgical procedure between 2008 and 2018 from Clalit well being companies—which insures over half of the Israeli inhabitants (roughly 4.8 million sufferers).
In whole, 822 members (72% females; common age 58 years) with no prior historical past of ischemic coronary heart illness, ischemic stroke, congestive coronary heart failure, or GLP-1RA remedy earlier than surgical procedure have been included within the research.
Every participant handled with a GLP-1RA post-surgery was matched with one other affected person who underwent bariatric surgical procedure alone, based mostly on intercourse, age, BMI at first of the research, and the variety of years since surgical procedure.
They have been adopted from the beginning of GLP-1RA remedy till the tip of December 2023 to evaluate adjustments in BMI and blood glucose ranges, in addition to the incidence of a primary MACE or loss of life.
Throughout a mean follow-up of round 1.7 years, 18 sufferers have been identified with a brand new MACE or died. The evaluation discovered that new instances of MACE or loss of life from any trigger occurred in 13 of 411 (3.2%) surgery-only sufferers and in 5 of 411 (1.2%) sufferers handled with a GLP-1RA post-surgery—with GLP-1RA remedy linked to a 67% discount in MACE or loss of life.
The researchers additionally discovered that individuals who began GLP-1RA remedy after surgical procedure had larger weight and blood sugar ranges at first, however over time, each dropped and have become much like those that had solely the surgical procedure.
The research is restricted due to the small variety of members and additional analysis is required to find out if these findings are generalizable to different folks.
However, “these results represent the first phase of the study, focusing on real-life data showing that people who did not achieve sufficient weight loss and diabetes control after surgery often started GLP-1RA treatment later, which enabled them to achieve weight and blood sugar levels similar to those who had more successful surgery results,” stated co-lead creator Professor Reges.
She added, “This phase also evaluated whether starting GLP-1RAs is linked to a first occurrence of major cardiovascular events (MACE). To better understand and confirm this potential link, the next phase of the study will apply a target trial emulation approach.”
In accordance with co-lead creator Professor Dror Dicker from Hasharon Hospital, Rabin Medical Middle, Israel, “These findings add to the rising proof of the cardiovascular advantages of GLP-1RAs and underscore their potential as an extra remedy choice for the administration of cardiovascular well being for the rising variety of folks affected by weight problems.
“Further large, rigorous clinical trials are needed before any firm conclusions can be drawn about the effectiveness and safety of GLP-1RA treatment after bariatric surgery, and to determine the timing for which this intervention is optimal.”
Offered by
European Affiliation for the Research of Weight problems
Quotation:
Standard weight-loss medication following bariatric surgical procedure might supply extra cardiovascular advantages, analysis signifies (2025, Might 13)
retrieved 13 Might 2025
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