Comparative effectiveness of bariatric surgeries in patients with obesity and type 2 diabetes mellitus: A network meta‐analysis of randomized controlled trials

Summary A network meta‐analysis of randomized controlled trials (RCTs) was performed to determine the hierarchies of different bariatric surgeries in patients with obesity and type 2 diabetes mellitus (T2DM), in terms of diabetes remission and cardiometabolic outcomes. Seventeen RCTs and six bariatr...

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Bibliographic Details
Published in:Obesity reviews 2020-08, Vol.21 (8), p.e13030-n/a
Main Authors: Ding, Li, Fan, Yuxin, Li, Hui, Zhang, Yalan, Qi, Dongwang, Tang, Shaofang, Cui, Jingqiu, He, Qing, Zhuo, Chuanjun, Liu, Ming
Format: Article
Language:English
Subjects:
Anastomosis
bariatric surgeries
Bariatric Surgery - methods
Bariatric Surgery/Obesity Comorbidity
Blood pressure
cardiometabolic outcome
Cholesterol
Clinical trials
Density
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - therapy
diabetes remission
Diastolic pressure
Female
Gastrectomy
Gastric bypass
Gastrointestinal surgery
Hierarchies
High density lipoprotein
Humans
Laparoscopy
Low density lipoprotein
Male
Meta-analysis
Middle Aged
Network Meta-Analysis
Obesity
Obesity - complications
Obesity - surgery
Patients
Randomization
Randomized Controlled Trials as Topic
Remission
Remission (Medicine)
Surgery
Treatment Outcome
Triglycerides
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Summary:Summary A network meta‐analysis of randomized controlled trials (RCTs) was performed to determine the hierarchies of different bariatric surgeries in patients with obesity and type 2 diabetes mellitus (T2DM), in terms of diabetes remission and cardiometabolic outcomes. Seventeen RCTs and six bariatric surgeries, including single anastomosis (mini) gastric bypass (mini‐GBP), biliopancreatic diversion without duodenal switch (BPD), laparoscopic‐adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), Roux‐en‐Y gastric bypass (RYGBP), greater curvature plication (GCP) and nonsurgical treatments (NST) were included. Mini‐GBP, BPD, LSG, RYGBP and LAGB (from best to worst), as compared with NST, were all significantly associated with the remission of T2DM. For the follow‐up period > 3 years, BPD, mini‐GBP, RYGBP and LSG (from best to worst) were significantly superior to NST in achieving the remission of T2DM. For secondary outcomes, the overall ranking for bariatric surgeries was RYGBP > BPD > LSG > LAGB after comprehensively weighting glucose, weight, systolic and diastolic pressure, total cholesterol, triglycerides, high‐density lipoprotein cholesterol (HDL‐C) and low‐density lipoprotein cholesterol (LDL‐C). Mini‐GBP has the greatest probability of achieving diabetes remission in adults with obesity and T2DM, yet BPD was the most effective in long‐term diabetes remission. RYGBP appears to be the most favourable alternative treatment to manage patients with cardiometabolic conditions.
ISSN:1467-7881
1467-789X
DOI:10.1111/obr.13030