Clinical outcomes of roux-en-Y gastric bypass versus medical therapy in type 2 diabetes mellitus: a systematic review and meta-analysis.

IF 1.6 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes and Metabolic Disorders Pub Date : 2025-01-10 eCollection Date: 2025-06-01 DOI:10.1007/s40200-024-01526-z

Dua Gul, Aimen Waqar Khan, Muhammad Abdurrahman Butt, Mahammed Khan Suheb, Sahil Sartaj, Sohanjeet Chabria, Rimsha Bint-E-Hina, Maryam Shaukat, Zeeshan Ali, Shirirang Kishor Bhurchandi, Abdul Ahad Syed, Mahima Khatri, Satesh Kumar

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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.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-024-01526-z.

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roux-en-Y胃旁路治疗与药物治疗对2型糖尿病的临床疗效：一项系统综述和荟萃分析

背景：肥胖发病率的增加导致2型糖尿病（T2DM）及其相关并发症的比例上升。我们的目的是比较Roux-en-y胃旁路手术（RYGB）和传统医疗管理对2型糖尿病肥胖患者的长期疗效。方法：检索PubMed、谷歌Scholar和Clinicaltrial.gov，检索时间为建站至2023年9月。本荟萃分析包括随机对照试验（RCTs）和队列研究。主要结果为1、2、3和5年T2DM缓解，以及ADA复合三联治疗目标的实现。采用修订后的Cochrane偏倚风险工具2.0和New-Castle Ottawa量表评估研究质量。该荟萃分析在PROSPERO CRD42023466324上进行前瞻性注册。结果：在我们最初的研究中获得的3323项研究中，有22项纳入了本证据分析，共有5176名患者（RYGB组和常规医疗管理组分别有1984和3192名患者）。与常规医疗管理组相比，RYGB组ADA复合三联治疗目标的完成率显著增加（RR 2.41, 95% CI 1.39-4.15， p值0.002,I2 35%）。患者接受RYGB手术1、2、3和5年后，糖尿病缓解是临床成功的结果(1年；RR 4.74, 95%CI 2.46 ~ 9.12， p值2%，2年；RR 8.95, 95% CI 1.71 ~ 46.71， p值0.009，I2 92%3年；RR 18.18 95%CI 7.57 ~ 43.62， p值2%，5年；RR 0.22, 95% CI 2.31-16.75， p值0.0003,I2 = 71%)。结论：对所给数据进行汇总分析，得出RYGB手术治疗T2DM患者比常规医疗管理更有效的结论。补充信息：在线版本提供补充资料，网址为10.1007/s40200-024-01526-z。

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来源期刊

Journal of Diabetes and Metabolic Disorders Medicine-Internal Medicine

CiteScore

4.80

自引率

3.60%

发文量

210

期刊介绍： Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.