Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Aug;21(8):e13030.
doi: 10.1111/obr.13030. Epub 2020 Apr 14.

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

Li Ding  1 , Yuxin Fan  1 , Hui Li  1 , Yalan Zhang  1 , Dongwang Qi  1 , Shaofang Tang  1 , Jingqiu Cui  1 , Qing He  1 , Chuanjun Zhuo  2 , Ming Liu  1
Affiliations
Review

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

Li Ding et al. Obes Rev. 2020 Aug.

Abstract

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.

Keywords: bariatric surgeries; cardiometabolic outcome; diabetes remission; network meta-analysis.

PubMed Disclaimer

Conflict of interest statement

The authors confirm that there are no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Ranking of bariatric surgeries according to primary and secondary outcomes. A, SUCRA value for remission of diabetes (all duration); B, SUCRA value for remission of diabetes (follow‐up > 3 years); C, cumulative SUCRA value after normalization for eight secondary outcomes (0–100). Every bariatric surgery was normalized with points up to a maximum of 12.5 for eight secondary outcomes, including glucose, weight loss, systolic pressure, diastolic pressure, total cholesterol, triglyceride, HDL‐C and LDL‐C, with an overall maximum score of 100. BPD, biliopancreatic diversion without duodenal switch; GCP, greater curvature plication; LAGB, laparoscopic‐adjustable gastric banding; LSG, laparoscopic sleeve gastrectomy; mini‐GBP, single anastomosis (mini) gastric bypass; NST, nonsurgical treatment; RYGBP, Roux‐en‐Y gastric bypass; SUCRA, surface under the cumulative ranking curve
See this image and copyright information in PMC

References

    1. Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet. 2017;389(10085):2239‐2251. - PubMed
    1. Collaboration NCDRF . Worldwide trends in diabetes since 1980: a pooled analysis of 751 population‐based studies with 4.4 million participants. Lancet. 2016;387(10027):1513‐1530. - PMC - PubMed
    1. Disease GBD, Injury I, Prevalence C. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211‐1259. - PMC - PubMed
    1. Kramer H, Cao G, Dugas L, Luke A, Cooper R, Durazo‐Arvizu R. Increasing BMI and waist circumference and prevalence of obesity among adults with type 2 diabetes: the National Health and Nutrition Examination Surveys. J Diabetes Complications. 2010;24(6):368‐374. - PubMed
    1. Jenkinson CP, Goring HH, Arya R, Blangero J, Duggirala R, DeFronzo RA. Transcriptomics in type 2 diabetes: bridging the gap between genotype and phenotype. Genom Data. 2016;8:25‐36. - PMC - PubMed