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Obesity Surgery
Erschienen in: Obesity Surgery 12/2019

27.10.2019 | Review

Remission of Type 2 Diabetes and Sleeve Gastrectomy in Morbid Obesity: a Comparative Systematic Review and Meta-analysis

verfasst von: Ferdous Madadi, Rami Jawad, Ismail Mousati, Philip Plaeke, Guy Hubens

Erschienen in: Obesity Surgery | Ausgabe 12/2019

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Abstract

Background

The sleeve gastrectomy (SG) has gained popularity which has resulted in a rising number of patients with T2DM to undergo this procedure. This systematic review and meta-analysis aimed to compare the long-term effects of SG on T2DM remission with remission seen after Roux-en-Y gastric bypass (RYGB) or gastric banding (GB).

Methods

A literature search was performed in PubMed and Cochrane Library using the following search terms: ‘sleeve gastrectomy’, ‘diabetes’, ‘gastric bypass’ and ‘gastric banding’. Studies published between January 2000 and April 2018, and with following inclusion criteria were selected for this review: BMI ≥ 35 kg/m2, age ≥ 18 years, follow-up ≥ 1 year, T2DM. Data was statistically analysed using a random-effects model and results were expressed as odds ratio with 95% confidence interval.

Results

After exclusion, 35 out of an initial 748 studies, consisting of 18 138 T2DM patients, remained for inclusion. Of these patients, 2480 underwent a SG. The remaining patients underwent a RYGB (n = 10,597) or GB (n = 5061). One year postoperatively, SG patients reached significantly (OR 0.71, p = 0.003) less T2DM remission than RYGB. After stratifying for different criteria for remission, RYGB still tended to result in higher remission rates, but the difference was not statistically significant. Beyond 1 year of follow-up, the difference between RYGB and SG in terms of T2DM remission decreased. SG was superior to the GB (OR 2.17, p = 0.001) after 1 year of follow-up.

Conclusion

This review demonstrates important remission of T2DM following SG. Nevertheless, as remission was significantly more often observed following RYGB surgery, the latter procedure remains the gold standard for reaching T2DM remission in patients with concurrent obesity.
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Metadaten
Titel
Remission of Type 2 Diabetes and Sleeve Gastrectomy in Morbid Obesity: a Comparative Systematic Review and Meta-analysis
verfasst von
Ferdous Madadi
Rami Jawad
Ismail Mousati
Philip Plaeke
Guy Hubens
Publikationsdatum
27.10.2019
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 12/2019
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04199-3

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