Meta-analysis of bariatric surgery versus non-surgical treatment for type 2 diabetes mellitus.
BACKGROUND
To compare short-term and long-term results of bariatric surgery vs non-surgical treatment for type 2 diabetes mellitus (T2DM).


METHODS
A systematic search was conducted in the PubMed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs). All statistical analysis was performed using Review Manager version 5.3. The dichotomous data was calculated using risk ratio (RR) and continuous data was using mean differences (MD) along with 95% confidence intervals (CI).


RESULTS
A total of 8 RCTs with 619 T2DM patients were analyzed. Compared with non-surgical treatment group, bariatric surgery group was associated with higher rate T2DM remission (RR = 5.76, 95%CI:3.15-10.55, P < 0.00001), more reduction HbA1C (MD = 1.29, 95%CI: -1.70 to -0.87, P < 0.00001), more decrease fasting plasma glucose (MD = -36.38, 95%CI: -51.76 to -21.01, P < 0.00001), greater loss body weight (MD = -16.93, 95%CI: 19.78 to -14.08, P < 0.00001), more reduction body mass index (MD = -5.80, 95%CI: -6.95 to -4.64, P < 0.00001), more decrease triglyceride concentrations (MD = -51.27, 95%CI: -74.13 to -28.41, P < 0.0001), and higher increase density lipoprotein cholesterol (MD = 9.10, 95%CI: 7.99 to 10.21; P < 0.00001). But total and low density lipoprotein cholesterol were no significant changes.


CONCLUSIONS
Bariatric surgery for T2DM is efficacious and improves short- and long-term outcomes as compared with non-surgical treatment.
Department of General Surgery, The 101st Hospital of Chinese PLA, Wuxi, Jiangsu, China.
Guo-Zhong
GZ
Wu
Department of General Surgery, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Jiangsu, China.
Bing
B
Cai
Department of General Surgery, The 101st Hospital of Chinese PLA, Wuxi, Jiangsu, China.
Feng
F
Yu
Department of General Surgery, The 101st Hospital of Chinese PLA, Wuxi, Jiangsu, China.
Zheng
Z
Fang
Health Science Center, Jiangsu University, Zhenjiang, Jiangsu, China.
Xing-Li
XL
Fu
Nanjing Lishui People's Hospital, Nanjing, Jiangsu, China.
Hai-Sen
HS
Zhou
Health Science Center, Jiangsu University, Zhenjiang, Jiangsu, China.
Wen
W
Zhang
Department of General Surgery, The 101st Hospital of Chinese PLA, Wuxi, Jiangsu, China.|Department of General Surgery, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Jiangsu, China.
Zhi-Qiang
ZQ
Tian
D050110:Bariatric Surgery / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D006801:Humans; D011788:Quality of Life; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol
bariatric surgery; meta-analysis; non-surgical treatment; type 2 diabetes mellitus