Clinical research studyWeight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis
Section snippets
Search Strategy for Identification of Studies
We conducted a comprehensive review of all studies published in the English literature containing data on weight loss and type 2 diabetes-related outcomes for patients treated with any form of bariatric surgery. We performed an electronic search in MEDLINE, Current Contents, and the Cochrane Library for interventional or observational studies published from January 1, 1990, to April 30, 2006. Search terms used were as follows: obesity/surgery (MeSH) OR gastric bypass OR gastroplasty OR
Search Yields
Initially, a total of 4402 citations were screened and 1817 full publications were retrieved, yielding 621 primary studies that met criteria for inclusion in the extractable and analyzable dataset (Figure 1). These primary studies were associated with an additional 558 kin studies, which occasionally contributed additional data of interest, such as data on subgroups.
Study Characteristics
The dataset consists of 621 studies with 888 treatment arms and 135,246 patients; 103 arms with 3188 patients reported on the
Discussion
The prevalence of type 2 diabetes has markedly increased in the last decade in the United States8, 9, 10 and globally.11, 12, 13 These data are correlated with a comparably steep increase in the prevalence of obesity.14, 15, 16, 17 The primary risk factor for type 2 diabetes is obesity, and 90% of all patients with type 2 diabetes are overweight or obese.18, 19 The National Health and Nutrition Examination Survey III (1988-1994) data showed that the risk for chemical diabetes is approximately
Conclusions
This systematic review and meta-analysis demonstrates that bariatric surgery has a powerful treatment effect in morbidly obese persons with type 2 diabetes. In the studies reporting only diabetic patients, 82% of patients had resolution of the clinical and laboratory manifestations of diabetes in the first 2 years after surgery, and 62% remained free of diabetes more than 2 years after surgery (80% and 75% for the total group). Randomized clinical trials comparing surgery and medical therapies
References (38)
- et al.
Assessing the quality of reports of randomized clinical trials: is blinding necessary?
Control Clin Trials
(1996) - et al.
Metaanalysis in clinical trials
Control Clin Trials
(1986) - et al.
Relationship between obesity, insulin resistance, and coronary heart disease risk
J Am Coll Cardiol
(2002) - et al.
The gastric bypass operation reduces the progression and mortality of non-insulin dependent diabetes mellitus
J Gastrointest Surg
(1997) - et al.
Impact of gastric bypass operation on survival: a population-based analysis
J Am Coll Surg
(2004) - et al.
Effect of 24 hours of starvation on plasma glucose and insulin concentrations in subjects with untreated non-insulin-dependent diabetes mellitus
Metab Clin Exp
(1996) - et al.
Trends in mortality in bariatric surgery: a systematic review and meta-analysis
Surgery
(2007) - et al.
Bariatric surgery: a systematic review and meta-analysis
JAMA
(2004) - et al.
Levels of Evidence and Grades of RecommendationCentre for Evidence-Based Medicine, October 2006
- et al.
Random effects models for effect sizes
The comparison of percentages in matched samples
Biometrika
Quantifying heterogeneity in a meta-analysis
Stat Med
Diabetes trends in the U.S.: 1990-1998
Diabetes Care
The evolving diabetes burden in the United States
Ann Intern Med
Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health And Nutrition Examination Survey 1999-2002
Diabetes Care
Global prevalence of diabetes
Diabetes Care
Obesity and diabetes in the developing world—a growing challenge
N Engl J Med
The World Health Report 2006Working Together for Health
Chronic hunger and obesity epidemics eroding global progress
Cited by (2074)
Comparison of various prediction models in the effect of Roux-en-Y gastric bypass on type 2 diabetes in the Chinese population 5 years after surgery
2023, Surgery for Obesity and Related DiseasesComparing bariatric surgery and medical therapy for obese adolescents with type 2 diabetes
2023, Asian Journal of SurgeryPharmacotherapy for obesity: moving towards efficacy improvement
2024, Diabetology and Metabolic SyndromeThe changes on salivary flow rates, buffering capacity and chromogranin A levels in adults after bariatric surgery
2024, Clinical Oral Investigations
Funding: This work was supported by Ethicon Endo-Surgery, Inc, a Johnson & Johnson Company, Cincinnati, Ohio.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.