Roux-en-Y gastric bypass versus best medical treatment for type 2 diabetes mellitus in adults with body mass index between 27 and 32 kg/m2: A 5-year randomized controlled trial

Metabolic bariatric surgery as a therapeutic option for patients with type 2 diabetes: A meta‐analysis and network meta‐analysis of randomized controlled trials

“…The present meta‐analysis confirms that metabolic surgery has a greater efficacy than non‐surgical therapy in determining reduction of HbA1c and diabetes remission in overweight and obese patients with T2D. This result is in line with those of previous meta‐analyses 13,70 that also included shorter‐term studies (possibly distorting the estimates of longer‐term efficacy of different therapeutic approaches) and which could not include some recent randomized trials 25,58,64,71 …”

“…After that, 876 and 84 items were excluded by reading the abstract and after reviewing the full text, respectively; the reasons for exclusion ( n = 84 items) are reported in Table S4. Out of 36 trials fulfilling all the inclusion criteria, 19 enrolled only patients with T2D, 24‐47 whereas 17 45,48‐62 included wider populations and provided separate subgroup analyses for patients affected by diabetes. Thirteen 25‐28,30,33‐38,61,63 and 26 trials 24,29,31,32,34,37,39,40,45,46,48‐59,62‐65 compared metabolic surgery with LSI/MT and with other types of metabolic surgery, respectively.…”

“…Out of 36 trials fulfilling all the inclusion criteria, 19 enrolled only patients with T2D, 24‐47 whereas 17 45,48‐62 included wider populations and provided separate subgroup analyses for patients affected by diabetes. Thirteen 25‐28,30,33‐38,61,63 and 26 trials 24,29,31,32,34,37,39,40,45,46,48‐59,62‐65 compared metabolic surgery with LSI/MT and with other types of metabolic surgery, respectively. Three trials compared metabolic surgery both with LSI/MT and other types of metabolic surgery 34,37,63 …”

“…Thirteen trials 25–28,30,33–38,61,63 compared bariatric surgery with MT. The types of surgery included LAGB, RYGB 16–24,26–28,30–35,37,38,43–45 and BPD, as specified in Table S5.…”

“…No specific trial on MBS has been performed enrolling only overweight, but not obese, patients with T2D. Only a few trials 25,32,33,36,37,39,46,59,61 allowed the inclusion of patients with a BMI of 25‐30 kg/m 2 , who represented only a minority of the enrolled patients. Based on the little available evidence, MBS appears to be effective on glycaemic control in overweight non‐obese patients with T2D.…”