Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies
Abstract Background This study aims to quantify the difference between Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) concerning the incidence of post-bariatric surgery hypoglycemia (PBSH) and variations in glycemic homeostasis. Main body of the abstract A literature searc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-11-01
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| Series: | Bulletin of the National Research Centre |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42269-023-01145-3 |
| _version_ | 1797454024096612352 |
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| author | Sotirios Artsitas Dimitrios Artsitas Spyridon Smparounis Dimitrios Theodorou George C. Zografos |
| author_facet | Sotirios Artsitas Dimitrios Artsitas Spyridon Smparounis Dimitrios Theodorou George C. Zografos |
| author_sort | Sotirios Artsitas |
| collection | DOAJ |
| description | Abstract Background This study aims to quantify the difference between Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) concerning the incidence of post-bariatric surgery hypoglycemia (PBSH) and variations in glycemic homeostasis. Main body of the abstract A literature search was conducted between July and August 2023. Inclusion criteria involved studies exclusively in the English language that comparatively investigated the occurrence of postoperative hypoglycemia in patients undergoing the above two bariatric approaches. A total of 16 studies, comprising data from 1806 patients, were identified and classified based on 39 primary and secondary outcomes pertaining to the period following the first postoperative semester. Our findings reveal that patients undergoing gastric bypass have a 50% higher risk of developing postoperative hypoglycemia compared to those undergoing sleeve gastrectomy. Moreover, this risk doubles when questionnaire data are taken into account. Lower glucose levels (MD = − 10.54 mg/dl, CI95% = [− 16.63; − 4.45]) were observed in the RYGB group at 2 h after an oral glucose tolerance test (OGTT), which is considered a precursor to the development of PBSH. Higher zenith (MD = 49.11 mg/dl, CI95% = [16.12; 82.10]) and lower nadir plasma glucose levels (MD = − 5.70 mg/dl, CI95% = [− 10.03; − 1.37]) were also noted in the same group, with a wider glucose range (MD = 52.22 mg/dl, CI95% = [18.25; 86.19]). Lastly, no differences were observed in insulin and C-peptide levels, glycosylated hemoglobin (HbA1c), as well as insulin sensitivity score (HOMA-IR). Short conclusion Patients in the RYGB group are at least 50% more likely to develop postoperative hypoglycemia compared to those in the LSG group. Our analysis suggests a more unstable glycemic homeostasis mechanism, with a strong contribution from late dumping syndrome. |
| first_indexed | 2024-03-09T15:31:16Z |
| format | Article |
| id | doaj.art-7e31657e96a6439f9b17aa15bac2196f |
| institution | Directory Open Access Journal |
| issn | 2522-8307 |
| language | English |
| last_indexed | 2024-03-09T15:31:16Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Bulletin of the National Research Centre |
| spelling | doaj.art-7e31657e96a6439f9b17aa15bac2196f2023-11-26T12:16:02ZengSpringerOpenBulletin of the National Research Centre2522-83072023-11-0147112910.1186/s42269-023-01145-3Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studiesSotirios Artsitas0Dimitrios Artsitas1Spyridon Smparounis2Dimitrios Theodorou3George C. Zografos4Geniko Nosokomeio Athenon Ippokrateio2nd Department of Orthopaedics, KAT HospitalGeniko Nosokomeio Athenon Ippokrateio1st Propaedeutic Department of Surgery, School of Medicine, National and Kapodistrian University of Athens (NKUA)1st Propaedeutic Department of Surgery, School of Medicine, National and Kapodistrian University of Athens (NKUA)Abstract Background This study aims to quantify the difference between Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) concerning the incidence of post-bariatric surgery hypoglycemia (PBSH) and variations in glycemic homeostasis. Main body of the abstract A literature search was conducted between July and August 2023. Inclusion criteria involved studies exclusively in the English language that comparatively investigated the occurrence of postoperative hypoglycemia in patients undergoing the above two bariatric approaches. A total of 16 studies, comprising data from 1806 patients, were identified and classified based on 39 primary and secondary outcomes pertaining to the period following the first postoperative semester. Our findings reveal that patients undergoing gastric bypass have a 50% higher risk of developing postoperative hypoglycemia compared to those undergoing sleeve gastrectomy. Moreover, this risk doubles when questionnaire data are taken into account. Lower glucose levels (MD = − 10.54 mg/dl, CI95% = [− 16.63; − 4.45]) were observed in the RYGB group at 2 h after an oral glucose tolerance test (OGTT), which is considered a precursor to the development of PBSH. Higher zenith (MD = 49.11 mg/dl, CI95% = [16.12; 82.10]) and lower nadir plasma glucose levels (MD = − 5.70 mg/dl, CI95% = [− 10.03; − 1.37]) were also noted in the same group, with a wider glucose range (MD = 52.22 mg/dl, CI95% = [18.25; 86.19]). Lastly, no differences were observed in insulin and C-peptide levels, glycosylated hemoglobin (HbA1c), as well as insulin sensitivity score (HOMA-IR). Short conclusion Patients in the RYGB group are at least 50% more likely to develop postoperative hypoglycemia compared to those in the LSG group. Our analysis suggests a more unstable glycemic homeostasis mechanism, with a strong contribution from late dumping syndrome.https://doi.org/10.1186/s42269-023-01145-3Roux-en-Y gastric bypassLaparoscopic sleeve gastrectomyBariatric surgeryHypoglycemiaMeta-analysis |
| spellingShingle | Sotirios Artsitas Dimitrios Artsitas Spyridon Smparounis Dimitrios Theodorou George C. Zografos Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies Bulletin of the National Research Centre Roux-en-Y gastric bypass Laparoscopic sleeve gastrectomy Bariatric surgery Hypoglycemia Meta-analysis |
| title | Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies |
| title_full | Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies |
| title_fullStr | Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies |
| title_full_unstemmed | Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies |
| title_short | Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies |
| title_sort | hypoglycemia rates and glycemic hormonal response after laparoscopic roux en y gastric bypass versus sleeve gastrectomy a meta analysis of comparative studies |
| topic | Roux-en-Y gastric bypass Laparoscopic sleeve gastrectomy Bariatric surgery Hypoglycemia Meta-analysis |
| url | https://doi.org/10.1186/s42269-023-01145-3 |
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