The Impact of Bariatric Surgery on Neuropathic Pain and on Objective Markers of Neuropathy

Background: Obesity (BMI ≥  30 kg/m2) is associated with T2 diabetes (40-fold relative risk) and cardiovascular complications. Bariatric surgery is becoming a treatment of choice in obese individuals because of the multiple benefits associated with significant weight loss leading to an improved quality of life and decreased morbidity and mortality, which far out weighs the cost of surgery. A major metabolic benefit is the remission from T2 diabetes as a consequence of alterations in gut hormone signaling and weight loss. Indeed cost-effectiveness analyses have led NICE to recommend that all patients with a BMI ≥  35 kg/m2 with T2 diabetes should be considered for bariatric surgery. In relation to the impact on macro vascular complications there is a significant reduction in MI and stroke in long term follow up studies, which translates to reduced mortality. For the microvascular complications of diabetes, studies are limited but have primarily focused on retinopathy and nephropathy after bariatric surgery...