Short- and long-term remission of obese type 2 diabetes mellitus after gastric bypass surgery or sleeve gastrectomy: a Meta analysis

Abstract

Objective To analyze the evidence-based study of short-term and long-term remission of type 2 diabetes mellitus(T2DM) after sleeve gastrectomy(SG) or gastric bypass surgery(GBP). Methods Related articles were systematically retrieved by searching Medline, Embase database, and Cochrane library. Inclusion and exclusion criteria to select literatures were set up. The data were qualitatively evaluated and analyzed by STATA or SPSS software. Results Thirty-four articles were involved including 8 randomized controlled trials (RCTs). Among them, 26 studies were on GBP surgeries and 27 on SG. The preoperative BMI of GBP and SG group were (44.8±5.2) kg/m2 and (46.68±7.3) kg/m2, preoperative glycosylated hemoglobin index were (7.86±0.73)% and (7.91±0.98)%, preoperative fasting plasma glucose were (158.0±18.1) mg/dl and (167.7±41.6)mg/dl, retrospectively. After 1 year of follow-up, the remission rate of T2DM was 77% and 74% in GBP and SG groups, while the remission rate was 74% and 85% in follow-up of 3 years. In follow-up of 5 or more years, the remission rate of SG surgery was 77%, while that of GBP group was 74% according to the Meta analysis. Comparing the remission rate of T2DM in GBP and SG group from the 8 RCTs, the RR was 1.26, 95% CI=1.10-1.44. The difference between the two groups was statistically significant (P<0.01). Conclusion Both SG and GBP surgeries are effective treatments for obese T2DM. The remission rate of GBP surgery is higher than SG. Key words: Sleeve gastrectomy(SG); Gastric bypass surgery(GBP); Type 2 diabetes mellitus; Long-term efficacy; Remission