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Efficacy of Metabolic Surgery on HbA1c Decrease in Type 2 Diabetes Mellitus Patients with BMI <35 kg/m2—a Review

Abstract

High glycated hemoglobin A1c (HbA1c) is strongly correlated with developing type 2 diabetes mellitus (T2DM) complications; this study reviews the efficacy of various types of metabolic surgeries in reducing HbA1c levels in type 2 diabetics with BMI <35 kg/m2. An electronic search of MEDLINE databases using terms ‘metabolic surgery’, type 2 diabetes mellitus, BMI <35 kg/m2, and related keywords for studies published between 1987 and 2013. Data from 53 articles with 2,258 patients were selected for this review. The weighted mean change in HbA1c was −2.8 % (95 % CI −2.8 to −2.7, p < 0.01) and weighted mean BMI change was −5.5 kg/m2 (95 % CI −5.6 to −5.4, p < 0.01). There was a strong correlation between weighted percentage mean change in HbA1c and BMI. Adjustable gastric banding and duodenal jejunal bypass were inferior to other surgeries in reducing BMI and HbA1c in BMI <35 kg/m2. Metabolic surgery significantly decreases HbA1c in T2DM patients with BMI <35 kg/m2 and that the magnitude of HbA1c change may be a useful surrogate of DM control.

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Appendix

Appendix

Table 4 Summary characteristics of study arms comparing metabolic surgical procedures in patients with BMI < 35 kg/m2 with T2DM

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Ngiam, K.Y., Lee, WJ., Lee, YC. et al. Efficacy of Metabolic Surgery on HbA1c Decrease in Type 2 Diabetes Mellitus Patients with BMI <35 kg/m2—a Review. OBES SURG 24, 148–158 (2014). https://doi.org/10.1007/s11695-013-1112-y

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Keywords

  • Body mass index <35 kg/m2
  • Type 2 diabetes mellitus
  • HbA1c
  • Metabolic surgery
  • Diabetes surgery
  • Diabetes remission
  • Non-obese
  • Non-morbidly obese
  • Roux-en-Y
  • Gastric bypass
  • Mini gastric bypass
  • Biliopancreatic bypass
  • Ileal interposition with sleeve gastrectomy
  • Duodenal jejunal bypass
  • Laparoscopic sleeve gastrectomy
  • Adjustable gastric banding