{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:04:01Z","timestamp":1791299041605,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,7]],"date-time":"2018-10-07T00:00:00Z","timestamp":1538870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Collaboration for Leadership in Applied Health Research and Care - East Midlands"},{"name":"NIHR CLAHRC West Midlands"},{"name":"NIHR Leicester Biomedical Research Centre"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bariatric surgery reduces cardiovascular events and mortality risk in obese individuals. However, it is unclear whether diabetes modifies this effect. This study examined mortality, cardiovascular, and cancer risk following bariatric surgery in adults with and without pre\u2010existing diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using mortality\u2010linked Hospital Episodes Statistics (2006\u201014) from England, the risk of death, myocardial infarction, stroke, unstable angina, heart failure, and cancer following bariatric surgery was examined; the risk of death in people undergoing surgery was also compared with mortality rates of the general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 35\u2009887 people undergoing bariatric surgery, 9175 (25.6%) had pre\u2010existing diabetes. During a mean follow\u2010up of 5.3 years, 801 people died, of whom 293 (36.6%) had pre\u2010existing diabetes. The risk of all\u2010cause mortality was 26% higher in people with than without diabetes (adjusted hazard ratio [aHR] 1.26, 95% confidence interval [CI] 1.08\u20101.46), whereas the risk of cancer was 21% higher (aHR 1.21; 95% CI 1.14\u20101.77). The risk of cardiovascular events was higher for patients with than without diabetes (aHRs [95% CIs] 2.08 [1.42\u20103.05], 1.80 [1.29\u20102.52], 1.61 [1.18\u20102.19], and 1.42 [1.14\u20101.77] for myocardial infarction, unstable angina, stroke, and heart failure, respectively). Compared with the general population, the age\u2010standardized mortality rate ratio was 1.70 (1.52\u20101.91) and 1.35 (1.23\u20101.48) in people with and without pre\u2010existing diabetes, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For patients with pre\u2010existing diabetes, the risk of death, cardiovascular events, and cancer after bariatric surgery was higher than for those without diabetes, whose mortality risk after surgery remains 35% higher than that of the general population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.12851","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T07:08:28Z","timestamp":1536304108000},"page":"265-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiovascular, cancer and mortality events after bariatric surgery in people with and without pre\u2010existing diabetes: A nationwide study"],"prefix":"10.1111","volume":"11","author":[{"given":"Nafeesa N.","family":"Dhalwani","sequence":"first","affiliation":[{"name":"Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2636-6487","authenticated-orcid":false,"given":"Francesco","family":"Zaccardi","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hina","family":"Waheed","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jemma","family":"Mytton","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitris","family":"Papamargaritis","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Webb","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Evison","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Lilford","sequence":"additional","affiliation":[{"name":"University of Warwick  Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie J.","family":"Davies","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre University of Leicester  Leicester UK"},{"name":"Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,7]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization (WHO).Obesity and overweight.2018.http:\/\/www.who.int\/mediacentre\/factsheets\/fs311\/en\/ Accessed August 20 2018."},{"key":"e_1_2_6_3_1","volume-title":"Statistics on Obesity, Physical Activity and Diet England, 2016","author":"Health and Social Care Information Centre","year":"2016"},{"key":"e_1_2_6_4_1","first-page":"1","article-title":"Prevalence of obesity among adults and youth: United States, 2011\u20102014","volume":"219","author":"Ogden CL","year":"2015","journal-title":"NCHS Data Brief"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035622"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2004.10.039"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1914"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066603"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.019"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0193"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(15)00334-4"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0901836"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31815c404e"},{"key":"e_1_2_6_14_1","volume-title":"Obesity: Identification, Assessment and Management","author":"National Institute for Health and Care Excellence","year":"2014"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-013-1079-8"},{"issue":"1","key":"e_1_2_6_16_1","first-page":"S1","article-title":"Standards of medical care in diabetes \u2010 2016","volume":"39","author":"American Diabetes Association","year":"2016","journal-title":"Diabetes Care"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-012-0677-1"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12941"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008862"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-0405"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.21.2005"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60576-4"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802987"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.5.942"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-2415"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30010-9"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.3.316"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2007.10.001"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(97)80112-6"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066254"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-016-4162-6"}],"container-title":["Journal of Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1753-0407.12851","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1753-0407.12851","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:58:38Z","timestamp":1694653118000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1753-0407.12851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,7]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/1753-0407.12851"],"URL":"https:\/\/doi.org\/10.1111\/1753-0407.12851","archive":["Portico"],"relation":{},"ISSN":["1753-0393","1753-0407"],"issn-type":[{"value":"1753-0393","type":"print"},{"value":"1753-0407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,7]]},"assertion":[{"value":"2018-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}