Clinical Research Papers:
Meta-analysis of bariatric surgery versus non-surgical treatment for type 2 diabetes mellitus
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Guo-zhong Wu1,*, Bing Cai2,*, Feng Yu1,*, Zheng Fang1, Xing-li Fu3, Hai-sen Zhou4, Wen Zhang3 and Zhi-qiang Tian1,2
1 Department of General Surgery, The 101st Hospital of Chinese PLA, Wuxi, Jiangsu, China
2 Department of General Surgery, Wuxi People’s Hospital, Nanjing Medical University, Wuxi, Jiangsu, China
3 Health Science Center, Jiangsu University, Zhenjiang, Jiangsu, China
4 Nanjing Lishui People’s Hospital, Nanjing, Jiangsu, China
* These authors have contributed equally to this work
Zhi-qiang Tian, email:
Keywords: bariatric surgery, type 2 diabetes mellitus, non-surgical treatment, meta-analysis
Received: July 10, 2016 Accepted: September 07, 2016 Published: September 10, 2016
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.
Conclusion: Bariatric surgery for T2DM is efficacious and improves short- and long-term outcomes as compared with non-surgical treatment.
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