The effect of bariatric surgery on diabetes related foot complications among patients with type 2 diabetes: A systematic review

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2024-07-14 DOI:10.1016/j.jdiacomp.2024.108813

Zhaonan Wang , Francesca L. Crowe , Abd A. Tahrani , Pushpa Singh , Jingya Wang , Luyuan Tan , Krishnarajah Nirantharakumar , Jonathan Hazlehurst

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引用次数: 0

Abstract

Background

Bariatric surgery leads to considerable weight loss and improved glycaemic control and seems to have a favourable impact on diabetes related foot complications (DFC).

Objectives

To assess the effect of bariatric surgery on diabetes related foot complications in patients with type 2 diabetes and determine whether DFC symptoms are improved after bariatric surgery.

Methods

We searched MEDLINE, Embase and Cochrane Central Register of Controlled Trials. The primary outcome was the presence of DFC after bariatric surgery. The secondary outcome was the improvement of DFC after bariatric surgery among patients who already had DFC before surgery.

Results

There were nine studies showing the presence of DFC post bariatric surgery and six detailing the changes in DFC post bariatric surgery. Bariatric surgery was not associated with a lower risk of developing or worsening DFC compared to conventional medical treatment based on 4 randomised control trials (IR 0.87, 95 % CI, 0.26, 2.98), while from observational studies was associated with 51 % lower risk of DFC (IR 0.49, 95 % CI, 0.31, 0.77). Bariatric surgery was associated with improvement in diabetic neuropathy assessment parameters including toe tuning fork score, self-reported neuropathy symptoms, neuropathy symptom score, and neuropathy symptom profile.

Conclusion

Bariatric surgery led to a greater reduction in developing or worsening DFC among patients with type 2 diabetes compared to medical treatment in observational studies, but not among RCTs. Bariatric surgery was associated with improvements in diabetic neuropathy related assessment parameters and symptoms. Bariatric surgery could be a promising treatment for patients with type 2 diabetes who are at high risk of DFC.

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减肥手术对 2 型糖尿病患者糖尿病足并发症的影响：系统综述

背景减肥手术会导致体重大幅下降，改善血糖控制，似乎对糖尿病相关足部并发症（DFC）有有利影响。目的评估减肥手术对 2 型糖尿病患者糖尿病相关足部并发症的影响，并确定减肥手术后 DFC 症状是否得到改善。主要结果是减肥手术后是否出现 DFC。结果有九项研究显示减肥手术后存在 DFC，有六项研究详细说明了减肥手术后 DFC 的变化。根据4项随机对照试验（IR为0.87，95% CI为0.26，2.98），与传统药物治疗相比，减肥手术与降低DFC发生或恶化的风险无关，而根据观察性研究，减肥手术与降低51%的DFC风险有关（IR为0.49，95% CI为0.31，0.77）。减肥手术与糖尿病神经病变评估参数的改善有关，这些参数包括脚趾音叉评分、自我报告的神经病变症状、神经病变症状评分和神经病变症状档案。减肥手术与糖尿病神经病变相关评估参数和症状的改善有关。减肥手术是一种很有前景的治疗方法，适用于DFC高风险2型糖尿病患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.