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Key outcomes: At the 10-year mark, patients who underwent metabolic surgery had significantly better outcomes: 32% lower risk of death 35% lower risk of major adverse cardiovascular events (MACE) , including heart attack, heart failure, or stroke 47% lower risk of chronic kidney disease (CKD) 54% lower risk of diabetes-related retinopathy (eye damage) The 10-year cumulative incidence of all-cause mortality was 9.0% (95% CI 6.810.8%) in the metabolic surgery group, compared with 12.4% (95% CI 9.915.2%) in the GLP-1RA group (adjusted hazard ratio 0.68, 95% CI 0.480.96

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Gastroenteritis Malnutrition Intestinal blockage or obstruction All these conditions canand haveled to hospitalization and/or death

PMID 23922466

This phase is where the most important evidence emerges