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The association of bariatric surgery with decreased incidence of diabetes was robust in several sensitivity analyses. When the entire comparison cohort of 103?502 obese individuals without diabetes was used for reference (rather than selected matched controls), learn more the adjusted hazard ratio for the effect of bariatric surgery on development of diabetes was 0��16 (95% CI 0��11�C0��22; pselleckchem pCofactor study to assess the effect of current bariatric surgical procedures on diabetes incidence in the context of usual care settings (panel). Even in patients seen in routine clinical practice, our results show that modern bariatric surgical procedures have particular effectiveness for diabetes prevention in obese patients. Systematic review We searched Scopus, Web of Science, PubMed, Medline, and Embase for studies published in English up to Sept 26, 2014, with the keywords: ��diabetes��, ��bariatric surgery��, ��prevention��, and ��incidence��. We retrieved no randomised controlled trials in which the incidence of diabetes after bariatric surgery was reported.7 We identified four cohort studies in which the development of diabetes after bariatric surgery was assessed,9, 20, 21?and?22 none of which were population based. The largest cohort was in the Swedish Obese Subjects (SOS) study,9 which comprised 1658 participants, with 69% receiving vertical banded gastroplasty, 19% gastric banding, and 12% gastric bypass from 1987 onwards. Other studies were smaller, with fewer than 300 participants; two only included people with prediabetes.20?and?22 All four studies suggested reduced occurrence of diabetes after bariatric surgery.