Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis
Abstract Background Bariatric surgery is superior to usual care for diabetes remission. Previous meta-analyses were limited by pooling observational and randomized trials, using various definitions of diabetes remission, and not controlling for various diabetes medications. The current meta-analysis...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
|
| Series: | Diabetology & Metabolic Syndrome |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13098-023-01001-4 |
| _version_ | 1797864037316296704 |
|---|---|
| author | Hyder Mirghani Ibrahim Altedlawi Albalawi |
| author_facet | Hyder Mirghani Ibrahim Altedlawi Albalawi |
| author_sort | Hyder Mirghani |
| collection | DOAJ |
| description | Abstract Background Bariatric surgery is superior to usual care for diabetes remission. Previous meta-analyses were limited by pooling observational and randomized trials, using various definitions of diabetes remission, and not controlling for various diabetes medications. The current meta-analysis aimed to compare bariatric surgery and usual care regarding the same. Methods We searched PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Library for relevant articles from the date of the first inception up to February 2023. The keywords diabetes remission, Bariatric surgery, metabolic surgery, lifestyles, usual care, GLIP-1 agonists, insulin use, gastric banding, biliopancreatic diversion, sleeve gastrectomy, and Roux-en-Y gastric bypass, were used. A datasheet was used to extract the relevant data. Results Diabetes remission (complete and prolonged) was higher among bariatric surgeries compared to usual care, odd ratio, 0.06, 95 CI, 0.02–0.25 and 0.12, 95 CI, 0.02–0.72, respectively. bariatric surgery patients were younger, had higher HbA1c, odd ratio, − 3.13, 95 CI, − 3.71 to 2.54, and 0.25, 95 CI, 0.02–0.48, respectively, insulin use was higher, and glucagon-like peptide agonists use was lower among bariatric surgery patients, odd ratio, 0.49, 95% CI, 0.24–0.97, and 3.06, 95% CI, 1.44–6.53, respectively. Conclusion Bariatric surgery was better than usual care in diabetes remission. Bariatric surgery patients were younger, had higher HbA1c, and received more insulin and lower GLP-1 agonists. No differences were evident regarding body mass index and the duration of diabetes. Further trials comparing the new anti-diabetic medications and different forms of bariatric surgery and controlling for the level of exercise and diet are recommended. |
| first_indexed | 2024-04-09T22:45:10Z |
| format | Article |
| id | doaj.art-b08dedfe5f824468abd55669d482e819 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-04-09T22:45:10Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-b08dedfe5f824468abd55669d482e8192023-03-22T11:55:53ZengBMCDiabetology & Metabolic Syndrome1758-59962023-02-0115111210.1186/s13098-023-01001-4Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysisHyder Mirghani0Ibrahim Altedlawi Albalawi1Department of Internal Medicine, Faculty of Medicine, University of TabukDepartment of Surgery, Faculty of Medicine, University of TabukAbstract Background Bariatric surgery is superior to usual care for diabetes remission. Previous meta-analyses were limited by pooling observational and randomized trials, using various definitions of diabetes remission, and not controlling for various diabetes medications. The current meta-analysis aimed to compare bariatric surgery and usual care regarding the same. Methods We searched PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Library for relevant articles from the date of the first inception up to February 2023. The keywords diabetes remission, Bariatric surgery, metabolic surgery, lifestyles, usual care, GLIP-1 agonists, insulin use, gastric banding, biliopancreatic diversion, sleeve gastrectomy, and Roux-en-Y gastric bypass, were used. A datasheet was used to extract the relevant data. Results Diabetes remission (complete and prolonged) was higher among bariatric surgeries compared to usual care, odd ratio, 0.06, 95 CI, 0.02–0.25 and 0.12, 95 CI, 0.02–0.72, respectively. bariatric surgery patients were younger, had higher HbA1c, odd ratio, − 3.13, 95 CI, − 3.71 to 2.54, and 0.25, 95 CI, 0.02–0.48, respectively, insulin use was higher, and glucagon-like peptide agonists use was lower among bariatric surgery patients, odd ratio, 0.49, 95% CI, 0.24–0.97, and 3.06, 95% CI, 1.44–6.53, respectively. Conclusion Bariatric surgery was better than usual care in diabetes remission. Bariatric surgery patients were younger, had higher HbA1c, and received more insulin and lower GLP-1 agonists. No differences were evident regarding body mass index and the duration of diabetes. Further trials comparing the new anti-diabetic medications and different forms of bariatric surgery and controlling for the level of exercise and diet are recommended.https://doi.org/10.1186/s13098-023-01001-4Bariatric surgeryMetabolic surgeryDiabetes remissionUsual careLifestyles |
| spellingShingle | Hyder Mirghani Ibrahim Altedlawi Albalawi Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis Diabetology & Metabolic Syndrome Bariatric surgery Metabolic surgery Diabetes remission Usual care Lifestyles |
| title | Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis |
| title_full | Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis |
| title_fullStr | Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis |
| title_full_unstemmed | Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis |
| title_short | Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis |
| title_sort | metabolic surgery versus usual care effects on diabetes remission a systematic review and meta analysis |
| topic | Bariatric surgery Metabolic surgery Diabetes remission Usual care Lifestyles |
| url | https://doi.org/10.1186/s13098-023-01001-4 |
| work_keys_str_mv | AT hydermirghani metabolicsurgeryversususualcareeffectsondiabetesremissionasystematicreviewandmetaanalysis AT ibrahimaltedlawialbalawi metabolicsurgeryversususualcareeffectsondiabetesremissionasystematicreviewandmetaanalysis |