Evidence map›Paper›PMID 28842774›Full record

ArticleSurgical endoscopy2018

The impact of bariatric surgery on insulin-treated type 2 diabetes patients.

Rodrigo Lemus, Dror Karni, Dennis Hong, Scott Gmora, Ruth Breau, Mehran Anvari

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Rodrigo LemusMcMaster University, G805, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
Dror KarniMcMaster University, G805, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
Dennis HongMcMaster University, G805, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
Scott GmoraMcMaster University, G805, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
Ruth BreauMcMaster University, G805, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
Mehran AnvariMcMaster University, G805, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada. anvari@mcmaster.ca.
McMaster University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBariatric surgery has been shown to lead to significant improvement in glucose homeostasis, resulting in greater rates of type 2 diabetes mellitus (T2DM) remission. While there is substantial evidence of the benefits of bariatric/metabolic surgery in obese diabetic patients on oral therapy (O-T2D), more evidence is necessary in the case of insulin-treated type 2 diabetes (I-T2D) patients and the selection of surgical procedure.

methodsAnalysis of the Ontario Bariatric Registry data was performed, comparing outcomes of Roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) on insulin-treated versus non-insulin-treated T2DM patients. We compared weight loss, medication use and remission rates during a 3-year follow up.

resultsA total of 3668 diabetic Bariatric Registry patients underwent surgery from Jan 2010 to Feb 2017, across 7 Bariatric Centers of Excellence in Ontario. Of these 2872 were O-T2D and 1187 were I-T2D. Weight loss was similar between the two groups at 3 years; with mean %WL of 30.1% for the insulin group vs. 28.3% non-insulin (p = 0.0673). At 3 years, 11.3% of the non-insulin and 59.6% of the insulin-dependent group were using anti-diabetic medication (p < 0.0001). Among insulin-dependent patients, RYGB showed greater reduction in insulin use with 26.5 and 40% compared to SG at 3 years. O-T2D patients experienced more complete diabetes remission, with 66.5 vs. 18.5% (p < 0.0001) at 3 years. Complete remission for I-T2D patients was higher in the RYGB group than SG (p < 0.0001) at years 1 and 2 (8.5 vs. 5.4% and 24.4 vs. 21.1%). The same trend was found regardless of insulin use; complete remission higher for RYGB at 1 and 2 years [50.7 vs. 39.8% (p < 0.0001), and 54.6 vs. 49.1% (p < 0.0001)].

conclusionWhile both RYGB and SG procedures provide effective treatment for I-T2D patients in terms of weight loss and diabetes, incidence of complete remission for insulin-dependent patients is higher with RYGB in earlier years.

Indexed as

GastrectomyGastric BypassDiabetes Mellitus, Type 2Follow-Up StudiesHumansHypoglycemic AgentsInsulinObesityOntarioRemission InductionTreatment OutcomeWeight LossHypoglycemic AgentsInsulinDiabetes mellitusGastric bypassInsulin dependenceRemissionSleeve gastrectomy

Identifiers

PMID28842774
OpenAlexW2749288052

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.