PDF(Pubmed)
Abstract：
UNASSIGNED: This study compared the effectiveness of 4 main revisional bariatric surgery (RBS) sequences after sleeve gastrectomy (SG) and adjustable gastric banding (AGB), on the reimbursement of antidiabetic treatments in France.
UNASSIGNED: Few large-scale prospective cohort studies have assessed the changes in antidiabetic treatments after RBS.
UNASSIGNED: This nationwide observational population-based cohort study analyzed data from the French National Health Insurance Database. All patients who underwent primary SG and AGB in France between January 2012 and December 2014 were included and followed up until December 31, 2020. The changes in categories and costs of reimbursed antidiabetic treatments across different RBS sequences were assessed (presented as follows: bariatric surgery (BS)-RBS).
UNASSIGNED: Among the 107,088 patients who underwent BS, 6396 underwent RBS, 2400 SG-GBP (SG converted to gastric bypass [GBP] during follow-up), 2277 AGB-SG, 1173 AGB-GBP, and 546 SG-SG. Pre-RBS insulin was used in 10 (2.9%), 4 (0.9%), 8 (2.4%), and 10 (2.6%) patients, respectively. Two years after RBS, the treatment discontinuation or decrease (the change of treatment to a lighter one category rates [eg, insulin to bi/tritherapy]) was 47%, 47%, 49%, and 34%, respectively. Four years after RBS, the median annual cost per patient compared with baseline was lower (P < 0.01) for all sequences, except SG-SG (P = 0.24). The most notable effect concerned AGB-GBP (median of more than 220 euros to 0).
UNASSIGNED: This study demonstrated the positive impact of RBS over a 4-year follow-up period on antidiabetic treatments reimbursement, through the reduction or discontinuation of treatments and a significant decrease in costs per patient.
UNASSIGNED: Few large-scale prospective cohort studies have assessed the changes in antidiabetic treatments after RBS.
UNASSIGNED: This nationwide observational population-based cohort study analyzed data from the French National Health Insurance Database. All patients who underwent primary SG and AGB in France between January 2012 and December 2014 were included and followed up until December 31, 2020. The changes in categories and costs of reimbursed antidiabetic treatments across different RBS sequences were assessed (presented as follows: bariatric surgery (BS)-RBS).
UNASSIGNED: Among the 107,088 patients who underwent BS, 6396 underwent RBS, 2400 SG-GBP (SG converted to gastric bypass [GBP] during follow-up), 2277 AGB-SG, 1173 AGB-GBP, and 546 SG-SG. Pre-RBS insulin was used in 10 (2.9%), 4 (0.9%), 8 (2.4%), and 10 (2.6%) patients, respectively. Two years after RBS, the treatment discontinuation or decrease (the change of treatment to a lighter one category rates [eg, insulin to bi/tritherapy]) was 47%, 47%, 49%, and 34%, respectively. Four years after RBS, the median annual cost per patient compared with baseline was lower (P < 0.01) for all sequences, except SG-SG (P = 0.24). The most notable effect concerned AGB-GBP (median of more than 220 euros to 0).
UNASSIGNED: This study demonstrated the positive impact of RBS over a 4-year follow-up period on antidiabetic treatments reimbursement, through the reduction or discontinuation of treatments and a significant decrease in costs per patient.
摘要：
■本研究比较了袖状胃切除术（SG）和可调式胃束带术（AGB）后4种主要的减重手术（RBS）序列的有效性，关于法国抗糖尿病治疗的报销。
■很少有大规模前瞻性队列研究评估RBS后抗糖尿病治疗的变化。
■这项全国性的基于观察人群的队列研究分析了来自法国国家健康保险数据库的数据。纳入2012年1月至2014年12月在法国接受原发性SG和AGB的所有患者，并随访至2020年12月31日。评估了不同RBS序列中报销的抗糖尿病治疗的类别和费用的变化（如下所示：减肥手术（BS）-RBS）。
■在107,088名接受BS治疗的患者中，6396接受RBS，2400SG-GBP（SG在随访期间转换为胃旁路术[GBP]），2277AGB-SG,1173AGB-GBP,和546SG-SG。前RBS胰岛素使用10（2.9％），4（0.9%），8（2.4%），和10名(2.6%)患者，分别。苏格兰皇家银行两年后，治疗停止或减少(治疗更改为较轻的一类率[例如，胰岛素对双/三联疗法])为47%，47%,49%,34%,分别。苏格兰皇家银行四年后，与基线相比，所有序列的每位患者的年费用中位数均较低（P<0.01），SG-SG除外(P=0.24)。最显着的影响涉及AGB-GBP（中位数超过220欧元至0）。
■这项研究证明了RBS在为期4年的随访期对抗糖尿病治疗报销的积极影响，通过减少或停止治疗以及每位患者的成本显着降低。
■很少有大规模前瞻性队列研究评估RBS后抗糖尿病治疗的变化。
■这项全国性的基于观察人群的队列研究分析了来自法国国家健康保险数据库的数据。纳入2012年1月至2014年12月在法国接受原发性SG和AGB的所有患者，并随访至2020年12月31日。评估了不同RBS序列中报销的抗糖尿病治疗的类别和费用的变化（如下所示：减肥手术（BS）-RBS）。
■在107,088名接受BS治疗的患者中，6396接受RBS，2400SG-GBP（SG在随访期间转换为胃旁路术[GBP]），2277AGB-SG,1173AGB-GBP,和546SG-SG。前RBS胰岛素使用10（2.9％），4（0.9%），8（2.4%），和10名(2.6%)患者，分别。苏格兰皇家银行两年后，治疗停止或减少(治疗更改为较轻的一类率[例如，胰岛素对双/三联疗法])为47%，47%,49%,34%,分别。苏格兰皇家银行四年后，与基线相比，所有序列的每位患者的年费用中位数均较低（P<0.01），SG-SG除外(P=0.24)。最显着的影响涉及AGB-GBP（中位数超过220欧元至0）。
■这项研究证明了RBS在为期4年的随访期对抗糖尿病治疗报销的积极影响，通过减少或停止治疗以及每位患者的成本显着降低。
