Sleeve gastrectomy versus Roux-en-Y Gastric Bypass for remission of type 2 diabetes mellitus at 1, 3 and 5 years: a systematic review and meta-analysis

• Published in: Minerva gastroenterology Vol. 68; no. 4; p. 450
• Main Authors: Fatima, Kaneez, Farooqui, Sabeeh K, Ajaz, Izma, Ali, Shaikh T, Hashmi, Nida, Nadeem, Sara, Ghazi, Sameed A, Kaleem, Shahzeb H, Bozdar, Fatima S, Noorani, Mushk
• Format: Journal Article
• Language: English
• Published: Italy 01-12-2022
• Subjects: Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - surgery; Gastrectomy - methods; Gastric Bypass - methods; Humans; Obesity; Obesity, Morbid - complications; Obesity, Morbid - surgery; Weight Loss
• ISSN: 2724-5365

Sleeve gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) are the two procedures used in the management of patient with obesity and type 2 diabetes mellitus (T2DM); however, it is still unclear which of the two is more efficient in the remission of type-2 diabetes mellitus.
The aim of this study was to analyze the efficiency of RYGB and SG in the remission of type-2 diabetes mellitus after 1, 3 and 5 years of surgery. Three databases (i.e., PubMed, Scopus, Central and Web of Science) were searched. All randomized control trial studies with at least 12-year follow-up were selected with type-2 diabetes mellitus in patients undergoing Roux-en-Y Gastric Bypass or sleeve gastrectomy. The broad and the narrow criteria were lined with individual patients reported, being analyzed and pooled using the random-effects model.
The 15 selected articles, including 707 obese type 2 diabetes patients, met the eligibility criteria for this meta-analysis. RYGB when compared with SG shows increased broad remissions (RR=1.43, 95% CI: 1.13-1.80; P=0.003) and narrow remissions (RR=1.32, 95% CI: 1.15-1.58; P=0.003) after one year of surgery, and broad remissions 5 years after surgery (RR=1.58, 95% CI: 0.97-2.56; P=0.06). No significant difference was identified between the two groups in broad and narrow remissions 3 years after surgery and narrow remissions 5 years after surgery.
Our results suggest that RYGB was more effective in the remission of type-2 diabetes mellitus at 1 year and 5 years considering the broad and narrow criteria, while there was no difference found 3 years after surgery.