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This study aimed to evaluate the effectiveness of only Roux-en-Y gastric bypass (RYGB) in patients with type 2 diabetes (T2D) and body mass index (BMI) of 30-40 kg/m. A literature search was performed on MEDLINE, Embase, and Cochrane CENTRAL. The searches were performed in February 2017. English was the target language of the publications. The PICO question was used to determine eligibility for studies to be included: population, patient with BMI 30-40 kg/m2; intervention, RYGB; comparison, control group with medical care alone; and outcome, metabolic outcomes. Only randomized clinical trials (RCT) were selected. The main outcome was T2D remission. Secondary outcomes were metabolic effect of RYGB, such as hypertension and dyslipidemia. A total of five RCTs were included. The studies included a larger proportion of women, and the average time of T2D duration ranged between 6 and 10 years with 43.3% of the patients having a BMI below 35 kg/m. Despite randomization, the baseline demographics such as age, HbA1c, and duration of diabetes were often less favorable in the surgical group. At the longest follow-up, RYGB significantly improves total and partial type 2 remission, OR 17.48 (95% CI 4.28-71.35) and OR 20.71 (95% CI 5.16-83.12), respectively. HbA1c also reduces at longest follow-up in the surgery group (- 1.83 (95% CI - 2.14; - 1.51)). All these three outcomes revealed high level of evidence according to GRADE evaluation. There is already strong evidence that RYGB improves metabolic outcomes for at least 5 years in patients with class I obesity.

BackgroundThis study aimed to evaluate the waiting time, safety, and effectiveness of bariatric surgery based on real-world data.MethodsThis is a noninterventional, noncomparative, and retrospective study with 300 morbidly obese patients who had undergone open Roux-en-Y surgery.ResultsThe procedure was found to be very safe, with low rates of overall complications (10.7%). Approximately 48.4% of the patients had reached a BMI <30 mg/kg2 at 12 months after surgery, while 6% were still classified as morbidly obese (BMI >40 mg/kg2). Comorbidity resolution was over 90% for all conditions, except for cardiovascular disease, which showed a 40% resolution. The mean number of drugs taken also decreased at 12 months after surgery.ConclusionsBariatric surgery was found to be effective in weight reduction and in the resolution of comorbidities.

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