Clinical outcomes of roux-en-Y gastric bypass versus medical therapy in type 2 diabetes mellitus: A systematic review and meta-analysis
Document Type
Article
Department
Medical College Pakistan
Abstract
Background: The growing incidence of obesity has led to a proportionate rise in type 2 diabetes mellitus (T2DM) and its associated complications. We aimed to compare the long-term outcomes of Roux-en-y Gastric Bypass surgery (RYGB) and conventional medical management in T2DM obese patients.
Methods: PubMed, Google Scholar, and Clinicaltrial.gov were searched from inception to September 2023. Randomized Controlled Trials (RCTs) and cohort studies were included in this meta-analysis. The primary outcomes were the T2DM remission at 1, 2, 3, and 5 years and the accomplishment of the ADA composite triple treatment goal. The revised Cochrane risk of bias tool 2.0 and New-Castle Ottawa scale were used to assess the quality of the studies. This meta-analysis was registered prospectively on PROSPERO CRD42023466324.
Results: Of the 3,323 studies yielded from our initial search, 22 were included in this evidence analysis, with 5,176 total patients (1,984 and 3,192 patients in RYGB and conventional medical management groups). A significant increase in the accomplishment in the ADA's composite triple treatment goal was observed in RYGB group as compared to the conventional medical management group (RR 2.41, 95% CI 1.39-4.15, p-value 0.002, I2 35%). Diabetes remission was a clinically successful outcome after 1, 2, 3, and 5 years of the RYGB surgery in the patients (1 year; RR 4.74, 95%CI 2.46-9.12, p-value < 0.00001, I2 0%, 2 years; RR 8.95, 95% CI 1.71-46.71, p-value 0.009, I2 92%3 years; RR 18.18 95%CI 7.57-43.62, p-value < 0.00001, I2 0%, 5 years; RR 0.22, 95% CI 2.31-16.75, p-value 0.0003, I2 = 71%).
Conclusion: The pooled analysis of the given data concluded that the RYGB surgery was more effective in treating T2DM in patients than conventional medical management.
Publication (Name of Journal)
Journal of Diabetes & Metabolic Disorders
DOI
10.1007/s40200-024-01526-z
Recommended Citation
Gul, D.,
Khan, A. W.,
Butt, M. A.,
Suheb, M. K.,
Sartaj, S.,
Chabria, S.,
Hina, R. B.,
Shaukat, M.,
Syed, A. A.
(2025). Clinical outcomes of roux-en-Y gastric bypass versus medical therapy in type 2 diabetes mellitus: A systematic review and meta-analysis. Journal of Diabetes & Metabolic Disorders, 24(1).
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_mc/513
Comments
Pagination is not provided by author/publisher.