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The Long-Term Effects of Bariatric Surgery on Type 2 Diabetes Remission, Microvascular and Macrovascular Complications, and Mortality: a Systematic Review and Meta-Analysis

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Abstract

This systematic review aimed to evaluate the long-term (≥ 5 years) outcomes of bariatric surgery on diabetes remission, microvascular and macrovascular events, and mortality among type 2 diabetes (T2D) patients. Ten articles (one randomized controlled trial and nine cohorts) met the inclusion criteria and were included in this review. Pooled estimates of nine cohort studies showed that surgery significantly increased the diabetes remission (relative risk (RR) = 5.90; 95% CI 3.75–9.28), reduced the microvascular (RR = 0.37; 95% CI = 0.30–0.46) and macrovascular events (RR = 0.52; 95% CI 0.44–0.61), and mortality (RR = 0.21; 95% CI 0.20–0.21) as compared to non-surgical treatment. Available evidence suggests better remission and lower risks of microvascular and macrovascular disease and mortality in the surgery group as compared to non-surgical treatment group in T2D patients after at least 5 years of follow-up.

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Acknowledgements

This study is partially supported by Department of Public Health Sciences and Center for China Study at Clemson University and Medical College at Xi’an Jiaotong University (support Dr. Sheng as a Visiting Scholar at Clemson University).

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Authors and Affiliations

  1. Department of Surgery, the First Affiliated Hospital, Medical College, Xi’an Jiaotong University, Xian Shi, China

    Binwu Sheng

  2. Department of Public Health Sciences, Clemson University, 511 Edwards Hall, 201 Epsilon Zeta Dr., Clemson, SC, 29634, USA

    Khoa Truong, Hugh Spitler, Lu Zhang & Liwei Chen

  3. Guizhou Health Development Research Center, Guizhou Medical University, Guiyang Shi, China

    Xuetao Tong

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  1. Binwu Sheng
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  2. Khoa Truong
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  4. Lu Zhang
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  6. Liwei Chen
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Contributions

All authors contributed to the development of study concepts; BS and XT extracted the data from the original articles; LC and LZ reviewed all the extracted data to check on information accuracy. BS and LC conducted the statistical analyses and drafted first version of the manuscript. All authors reviewed and edited on the manuscript.

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Correspondence to Liwei Chen.

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Sheng, B., Truong, K., Spitler, H. et al. The Long-Term Effects of Bariatric Surgery on Type 2 Diabetes Remission, Microvascular and Macrovascular Complications, and Mortality: a Systematic Review and Meta-Analysis. OBES SURG 27, 2724–2732 (2017). https://doi.org/10.1007/s11695-017-2866-4

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