Clinical Outcomes of Roux-en-Y Gastric Bypass Versus Medical Therapy in Type 2 Diabetes Mellitus: a Systematic Review and Meta-analysis

Overview

Journal J Diabetes Metab Disord

Date 2025 Jan 13

PMID 39801690

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

Affiliations

Soon will be listed here.

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, I 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 0%, 2 years; RR 8.95, 95% CI 1.71-46.71, p-value 0.009, I 92%3 years; RR 18.18 95%CI 7.57-43.62, p-value < 0.00001, I 0%, 5 years; RR 0.22, 95% CI 2.31-16.75, p-value 0.0003, I = 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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