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Does Metabolic Surgery Lead to Diabetes Remission in Patients with BMI < 30 kg/m2?: a Meta-analysis

  • Matilde Rubio-Almanza
  • David Hervás-Marín
  • Rosa Cámara-Gómez
  • Jana Caudet-Esteban
  • Juan Francisco Merino-Torres
Original Contributions
  • 28 Downloads

Abstract

Background

Bariatric surgery has demonstrated to be effective in remission of type 2 diabetes in obese patients, but it is unclear in non-obese patients. The aim of this study is to investigate if metabolic surgery is effective in diabetes resolution in patients with BMI < 30 kg/m2.

Materials and Methods

A systematic review was performed and the content of the PubMed, Ovid, and the Cochrane Library databases covering the period January 2008 to April 2018 was searched. Studies with metabolic surgery performed in patients with type 2 diabetes, BMI < 30 kg/m2 and a follow-up ≥ 6 months were included. Type 2 diabetes remission rate and metabolic parameters changes were measured. A meta-analysis was conducted with the selected studies.

Results

Twenty-six studies were included in the meta-analysis (1105 patients). The mixed-effects meta-analysis model for overall diabetes remission rate produced an estimate of 43% (95% IC 34–53%, p < 0.001). Moderator effects of the variables race, preoperative HbA1c, BMI, months of follow-up, duration of diabetes, and age on diabetes remission were also assessed, with no significant effects being found in any of them. A reduction in BMI (− 3.57 kg/m2), fasting blood glucose (− 55.93 mg/dL) and HbA1c (− 2.08%) was observed after surgery.

Conclusions

Metabolic surgery could be effective in remission of type 2 diabetes in BMI < 30 kg/m2 patients but randomized and long-term studies are necessary. The scientific community should agree in a single definition of type 2 diabetes remission, in order to know the real effect of metabolic surgery in this group of patients.

Keywords

Metabolic surgery Type 2 diabetes BMI < 30 kg/m2 Systematic review Meta-analysis 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interests.

Ethical Approval Statement

For this type of study, formal consent is not required.

Informed Consent Statement

Informed consent statement does not apply.

Supplementary material

11695_2018_3654_MOESM1_ESM.docx (27 kb)
Supplementary table Newcastle-Otawa scale. Quality assessment of the included studies in the meta-analysis. S1: Representativeness of the exposed cohort; S2: Selection of the non-exposed cohort; S3: Ascertainment of exposure; S4: Demonstration that outcome of interest was not present at start of study. O1: Assessment of outcome; O2: Was follow-up long enough for outcomes to occur; O3: Adequacy of follow up of cohorts (DOCX 26 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Endocrinology and Nutrition DepartmentHospital Universitario y Politécnico La FeValenciaSpain
  2. 2.Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética ClínicaInstituto de Investigación Sanitaria La Fe (Health Research Institute La Fe)ValenciaSpain
  3. 3.Biostatistics UnitInstituto de Investigación Sanitaria La Fe (Health Research Institute La Fe)ValenciaSpain

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