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The Effect of Bariatric Surgery on Asian Patients with Type 2 Diabetes Mellitus and Body Mass Index < 30 kg/m2: a Systematic Review and Meta-analysis

  • Guangnian Ji
  • Pengzhou Li
  • Weizheng Li
  • Xulong Sun
  • Zhaomei Yu
  • Rao Li
  • Liyong ZhuEmail author
  • Shaihong ZhuEmail author
Original Contributions

Abstract

Background

The effect of bariatric surgery on the glycemic control of patients with obesity and type 2 diabetes mellitus is obvious. However, the effect in patients with body mass index (BMI) < 30 kg/m2 especially Asian population has not been widely reported and acknowledged.

Methods

We performed a literature search in Medline, Embase, and the Cochrane Library from January 2000 to March 2018. All the studies involving the effect of bariatric surgery on patients with type 2 diabetes and BMI < 30 kg/m2 from Asian countries or regions were included in this meta-analysis.

Results

Twelve studies including 697 patients were examined in this meta-analysis. Clinical indexes in 6, 12, and 24 months follow-up were analyzed, respectively. BMI and waist circumference reduced by 2.88 kg/m2 and 12.92 cm, respectively, at 12 months postoperatively. There were reductions in fasting plasma glucose, 2-h postprandial plasma glucose, and glycated hemoglobin A1c at all the three time points after surgery, 3.13 mmol/L, 5.46 mmol/L, and 2.13% at 6 months; 3.22 mmol/L, 6.46 mmol/L, and 2.38% at 12 months; 1.99 mmol/L, 5.84 mmol/L, and 1.58% at 2 years. Insulin only reduced by 1.70 μU/ml at 12 months. C-peptide reduced by 0.70 ng/ml and 0.40 ng/ml at 6 months and 2 years. Bariatric surgery led to reduction in total cholesterol, triglyceride, and low-density lipoprotein cholesterol, while augment in high-density lipoprotein cholesterol at 6 and 12 months. Glucagon-like peptide 1 increased by 2.48 pmol/L and 4.00 pmol/L at half a year 1 year.

Conclusions

Asian patients with type 2 diabetes and BMI < 30 kg/m2 could achieve significant improvement in weight, glycemic control, lipid profiles, and β-cell function in short and medium terms after bariatric surgery, but long-term follow-up is necessary to evaluate the effectiveness.

Keywords

Bariatric surgery Type 2 diabetes BMI < 30 kg/m2 

Notes

Funding

The paper was supported by the National Natural Science Foundation of China (81600431) and the Natural Science Foundation of Hunan Province of China (2017JJ3471).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

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

Authors and Affiliations

  1. 1.Department of General Surgery, Third Xiangya HospitalCentral South UniversityChangshaChina

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