Network meta-analysis of the relative efficacy of bariatric surgeries for diabetes remission.

Abstract

BACKGROUND:

Bariatric surgery leads to a higher remission rate for type 2 diabetes mellitus than non-surgical treatment. However, it remains unsolved which surgical procedure is the most efficacious. This network meta-analysis aimed to rank surgical procedures in terms of diabetes remission.

METHODS AND FINDINGS:

We electronically searched for randomized controlled trials in which at least one surgical treatment was included among multiple arms and the diabetes remission rate was included in study outcomes. A random-effects network meta-analysis was performed within a frequentist framework. The hierarchy of treatments was expressed as the surface under the cumulative ranking curve value. Results of the analysis of 25 eligible randomized controlled trials that covered non-surgical treatments and eight surgical procedures (biliopancreatic diversion [BPD], BPD with duodenal switch, Roux-en Y gastric bypass, mini gastric bypass [mini-GBP], laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, greater curvature plication and duodenal-jejunal bypass) showed that BPD and mini-GBP had the highest surface under the cumulative ranking curve values among the eight surgical treatments.

CONCLUSION:

Current network meta-analysis indicated that BPD or mini-GBP achieved higher diabetes remission rates than the other procedures. However, the result needs to be interpreted with caution considering that these procedures were in the minority of bariatric surgeries.

• Authors: S Kodama, K Fujihara, C Horikawa, M Harada, H Ishiguro, M Kaneko, K Furukawa, Y Matsubayashi, S Matsunaga, H Shimano, S Tanaka, K Kato, H Sone
• Journal: Obesity reviews : an official journal of the International Association for the Study of Obesity (Obes Rev) Vol. 19 Issue 12 Pg. 1621-1629 (12 2018) ISSN: 1467-789X [Electronic] England
• PMID: 30270528 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
• Copyright: © 2018 World Obesity Federation.

Topics

• Bariatric Surgery (methods)
• Diabetes Mellitus, Type 2 (surgery)
• Humans
• Network Meta-Analysis
• Remission Induction (methods)
• Treatment Outcome