The Effects of Bariatric Procedures versus Medical Therapy for Obese Patients with Type 2 Diabetes: Meta-Analysis of Randomized Controlled Trials
Table 4
Summary of the effect of meta-analysis.
Outcomes
Comparison
Effect estimate
value
MD/SMD/RR
95% CI
Glycated hemoglobin
Gastric bypass
Medical therapy
0.00001
−0.97
−1.34, −0.60
Gastric banding
0.0001
−1.13
−1.68, −0.58
Gastrectomy
0.0001
−0.89
−1.32, −0.46
Biliopancreatic diversion
0.00001
−3.46
−4.52, −2.41
Fasting plasma glucose
Gastric bypass
Medical therapy
0.004
−23.44
−39.59, −7.29
Gastric banding
0.001
−32.80
−52.76, 12.84
Biliopancreatic diversion
0.00001
−41.86
−48.98, −34.74
Remission of diabetes
Bariatric surgery
Medical therapy
0.02
9.76
1.36, 69.66
Subjects with no diabetes medicines
Gastric bypass
Medical therapy
0.003
63
3.99, 995.29
Gastric banding
0.0002
6
2.37, 15.20
Gastrectomy
0.009
40.35
2.53, 643.98
Serious adverse events
Bariatric surgery
Medical therapy
0.34
1.23
0.80, 1.87
Body weight
Gastric bypass
Medical therapy
0.00001
−26.02
−30.47, −21.58
Gastric banding
0.00001
−19.60
−23.83, −15.37
Gastrectomy
0.00001
−19.70
−23.11, −16.29
Biliopancreatic diversion
0.00001
−29.08
−34.52, −23.64
Waist circumference
Gastric bypass
Medical therapy
0.00001
−15.11
−17.65, −12.58
Gastric banding
0.00001
−13.90
−18.95, −8.85
Gastrectomy
0.00001
−13.90
−16.91, −10.89
Biliopancreatic diversion
0.00001
−13.01
−16.07, −12.65
High-density lipoprotein
Gastric bypass
Medical therapy
0.00001
20.89
14.31, 27.47
Gastric banding
0.00001
10.00
5.87, 14.13
Gastrectomy
0.008
17.10
7.13, 27.07
Biliopancreatic diversion
0.16
6.95
−2.78, 16.68
Triglycerides
Gastric bypass
Medical therapy
0.77
−2.89
−22.00, 16.22
Gastric banding
0.01
−69.60
−124.07, −15.13
Biliopancreatic diversion
0.00001
−38.51
−41.09, −25.96
Systolic blood pressure
Gastric bypass
Medical therapy
0.46
1.82
−3.00, 6.64
Gastric banding
0.30
−4.30
−12.48, 3.88
Gastrectomy
0.72
−1.20
−7.75, 5.35
Biliopancreatic diversion
0.41
−3.40
−11.57, 4.77
Cholesterol total
Gastric bypass
Medical therapy
0.37
0.16
−0.19, 0.51
Gastric banding
0.72
0.09
−0.41, 0.60
Gastrectomy
0.37
0.19
−0.22, 0.60
Biliopancreatic diversion
0.00001
−2.75
−3.67, −1.82
SMD (standardized mean difference) was used when continuous outcomes was the same scale; MD (mean difference) was recommended when continuous outcomes was different scale; RR (risk ratio) was applied for dichotomous outcomes; CI (confidence interval).