Metaanalysis of the Resolution rate of Type 2 diabetes mellitus in patients undergoing Roux-en-Y gastric bypass surgery

Background One of the major comorbidities in obese and morbidly obese patients is Type 2 diabetes (T2DM) with approximately 20% of them suffering from this disease. The objective of this review was to determine the impact of Roux-en-Y gastric bypass (RYGB) surgery on the resolution rate of T2DM in obese diabetic patients.Methods A systematic review was made into the literature using MEDLINE database to search for relevant studies reporting the resolution or improvement of T2DM post RYGB. Data from the case series and systematic review were collected for different age groups and different degrees of obesity (obese,morbidly obese,super obese) and metaanalysed. The various other aspects of the surgery regarding the complications,mortality rate,cost analysis,improvement in quality of life were also reviewed. Results Data from 56 relevant studies were retrieved containing a total of 10289 patients. Metaanalysis of the data from case series and other systematic reviews showed that RYGB is an effective method for obtaining weight reduction in obese,morbidly obese patients and in elderly obese patients. The mean age of patients was 42.8 years,mean baseline BMI was 47.4 kg/m2.The mean percentage excess weight loss (%EWL) was 65.3% and mean change in BMI was 17.1 kg/m2.The mean resolution rate of diabetes was 76.4 % while the mean improved/resolved rate of T2DM was 87.4%. Conclusion RYGB is a highly effective method for patients of various degrees of obesity and different age groups for treatment of obesity and T2DM. It also appears to be an interesting option economically due to savings from diabetic medications which outweigh the costs of the surgery and follow-up coupled with increased quality of life.