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
{"title":"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","authors":"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","doi":"10.1007/s40200-024-01526-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, I<sup>2</sup> 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, I<sup>2</sup> 0%, 2 years; RR 8.95, 95% CI 1.71-46.71, p-value 0.009, I<sup>2</sup> 92%3 years; RR 18.18 95%CI 7.57-43.62, p-value < 0.00001, I<sup>2</sup> 0%, 5 years; RR 0.22, 95% CI 2.31-16.75, p-value 0.0003, I<sup>2</sup> = 71%).</p><p><strong>Conclusion: </strong>The pooled analysis of the given data concluded that the RYGB surgery was more effective in treating T2DM in patients than conventional medical management.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-024-01526-z.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 1","pages":"43"},"PeriodicalIF":1.6000,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723861/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical outcomes of roux-en-Y gastric bypass versus medical therapy in type 2 diabetes mellitus: a systematic review and meta-analysis.\",\"authors\":\"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\",\"doi\":\"10.1007/s40200-024-01526-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, I<sup>2</sup> 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, I<sup>2</sup> 0%, 2 years; RR 8.95, 95% CI 1.71-46.71, p-value 0.009, I<sup>2</sup> 92%3 years; RR 18.18 95%CI 7.57-43.62, p-value < 0.00001, I<sup>2</sup> 0%, 5 years; RR 0.22, 95% CI 2.31-16.75, p-value 0.0003, I<sup>2</sup> = 71%).</p><p><strong>Conclusion: </strong>The pooled analysis of the given data concluded that the RYGB surgery was more effective in treating T2DM in patients than conventional medical management.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-024-01526-z.</p>\",\"PeriodicalId\":15635,\"journal\":{\"name\":\"Journal of Diabetes and Metabolic Disorders\",\"volume\":\"24 1\",\"pages\":\"43\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-01-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723861/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Diabetes and Metabolic Disorders\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s40200-024-01526-z\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes and Metabolic Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40200-024-01526-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Clinical outcomes of roux-en-Y gastric bypass versus medical therapy in type 2 diabetes mellitus: a systematic review and meta-analysis.
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.
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.
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