{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:53:24Z","timestamp":1781722404148,"version":"3.54.5"},"reference-count":39,"publisher":"American Diabetes Association","issue":"9","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000738","name":"Department of Veterans Affairs","doi-asserted-by":"crossref","award":["RCS 10-391"],"award-info":[{"award-number":["RCS 10-391"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK125380"],"award-info":[{"award-number":["R01 DK125380"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Duke Clinical and Translational Science Institute","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Bariatric surgery lowers the risk of developing microvascular and macrovascular complications of type 2 diabetes, but it is unclear whether it also lowers long-term health expenditures in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>In a retrospective cohort study of 6,690 patients with obesity and type 2 diabetes who underwent bariatric surgery in 2012\u20132019 and 19,122 matched nonsurgical patients, we compared total, outpatient, inpatient, and medication expenditures 3 years presurgery and 5.5 years postsurgery, using generalized estimating equations. Expenditures were estimated in 6-month intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Surgical and nonsurgical cohorts were well-matched, with 73% female, average BMI 44 kg\/m2, mean age 50 years, and 32% on insulin. Estimated total expenditures were similar between surgical and nonsurgical patients up to 1 year presurgery. Total expenditures were significantly lower for surgical patients starting 1 year postsurgery and up to 5.5 years postsurgery compared with control patients ($566 lower per 6-month interval at 5.5 years; 95% CI \u2212$807, \u2212$316). Expenditure differences were largely attributable to a 56% drop in medication expenditures for surgical patients, from $2,204 in the 6 months presurgery to $969 per 6-month interval at 5.5 years postsurgery. Surgical patients had a higher probability of inpatient admission throughout the postsurgical period (4.0\u20136.5% vs. 2.4\u20133.1% per 6-month interval).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Patients with type 2 diabetes undergoing bariatric surgery have significantly lower total postsurgical expenditures than matched control patients, primarily because of substantial reductions in pharmacy expenditures. The long-term cost savings associated with bariatric surgery are likely to increase further, given the rapidly escalating costs of diabetes pharmacotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-0254","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T14:11:26Z","timestamp":1749737486000},"page":"1502-1511","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":6,"title":["Health Expenditures Decline After Bariatric Surgery for Patients With Type 2 Diabetes"],"prefix":"10.2337","volume":"48","author":[{"given":"Caroline E.","family":"Sloan","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine 1 , Durham, NC"},{"name":"Department of Population Health Sciences, Duke University School of Medicine 2 , Durham, NC"},{"name":"Duke-Margolis Institute for Health Policy 3 , Durham, 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