The Research Of The Effect And Prognosis Of Weight Loss Surgery On Diabetic Nephropathy And Retinopathy Of Obese Patient With T2DM

ObjectiveThe incidence of diabetes is increasing year by year.As one of the most common microvascular complications of diabetes,diabetic nephropathy causes a heavy burden on patients and society due to its high incidence and poor treatment.In recent years,studies have found that weight loss surgery can significantly reduce the weight of obese patients,but also can effectively improve postoperative blood glucose levels,diabetic nephropathy and other related complications of diabetes.In this paper,we study the risk factors of diabetic nephropathy,and the effects and prognosis of weight loss surgery on diabetic nephropathy and diabetic retinopathy of obese patients with type 2 diabetes.MethodsA total of 219 patients with diabetes mellitus were divided into the simple diabetes group and the diabetic nephropathy group according to the presence or absence of diabetic nephropathy.The differences between the clinical data of the two groups were compared to analyze the riskfactors of diabetic nephropathy in diabetic patients.A prospective study of 127 patients with obesity and type 2 diabetes who underwent weight loss surgery was performed.The follow-up period was one year.The differences in body weight,blood glucose levels,albuminuria,diabetic microvascular complications were compared between baseline and 1-year after surgery,to assess the effect and prognosis of weight loss surgery on such patients.ResultsThere are significant differences between diabetes group and diabetic nephropathy group in duration of diabetes,BMI,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,glomerular filtration rate,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,and the incidence of diabetes retinopathy.Multivariate binary logistic regression analysis of diabetic nephropathy shows that long-term diabetes,obesity,hypertension,high glycosylated hemoglobin,hyperlipidemia,and diabetic retinopathy are risk factors for diabetic nephropathy,high-density lipoprotein-cholesterol is a protective factor for diabetic nephropathy.The analysis of patients who had underwent weight loss surgery showed that the weight of patients,glycosylated hemoglobin,hypertension,dyslipidemia,glomerular hyperfiltration and diabetic nephropathy were significantlyimproved one year after the weight loss surgery,but diabetic retinopathy was not relieved significantly.ConclusionsLong duration of diabetes,obesity,hypertension,high glycosylated hemoglobin,dyslipidemia,and diabetic retinopathy are risk factors for diabetic nephropathy.Weight loss surgery can significantly alleviate blood glucose levels and diabetic nephropathy in obese patients with type2 diabetes and can be a treatment for these patients,but has no significant improvement in diabetic retinopathy.