829 Bariatric Surgery Versus Medical Therapy for the Management of Obesity in Patients With Type 2 Diabetes

Abstract

Abstract Aim The risks associated with Type 2 Diabetes (T2DM) and obesity are increasingly becoming relevant across the world. This review aims to compare the clinical outcomes of the Bariatric surgery versus medical therapy in management of obese patients with diabetes. Method A systematic, electronic search was performed according to PRISMA guidelines to identify relevant articles that compared outcomes of medical therapy versus the Bariatric surgery procedures for obesity in diabetic patients. Results Twelve studies were included, enrolling 4097 patients. A greater reduction in HbA1c (SMD -12.27, 95% CI[-16.99, -7.56]) and BMI (SMD -10.77, 95% CI[-12.59, -8.95]), was observed in the surgical group. Secondary outcomes, weight (SMD -2.14, 95% CI [-6.30, -1.21]), total cholesterol (SMD -5.78, 95% CI[-9.92, -1.65]), waist circumference (SMD = -5.24 [-9.20, -1.28]) and fasting glucose (SMD -3.75, 95% CI [-6.79, -1.19]) were statistically significant in favour of the Bariatric surgery approach. No significant differences were observed in the triglycerides (SMD -1.55 [-4.53, 1.42], p = 0.31) and diastolic blood pressure (SMD -0.12 [-1.14, 0.90], p = 0.82). Systolic blood pressure (SMD 1.26, 95% CI[0.42, 2.11]) was significantly in favour of medical therapy. Conclusions The Bariatric surgery approach is associated with a reduced HbA1c and BMI. However, the long-term benefits of the procedure need to be evaluated. This review calls for robust trials comparing the two techniques to further strengthen the evidence.