Evidence map›Paper›PMID 30402804›Full record

SynthesisObesity surgery2019

Outcomes of Bariatric Surgery Versus Medical Management for Type 2 Diabetes Mellitus: a Meta-Analysis of Randomized Controlled Trials.

Zhamak Khorgami, Saeed Shoar, Alan A Saber, C Anthony Howard, Goodarz Danaei, Guido M Sclabas

Abstract readComparative StudyMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

43 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Article
  7. How Do Trauma- and Violence-Informed Care Approaches Underpin Bariatric Surgery Interventions for Type 2 Diabetes Mellitus Remission? A Scoping Review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025
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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.

Zhamak KhorgamiDepartment of Surgery, College of Medicine, University of Oklahoma, 4502 E 41st Street, Tulsa, OK, 74135, USA. Zhamak-khorgami@ouhsc.edu.ORCID http://orcid.org/0000-0001-6144-691X
Saeed ShoarDepartment of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Bariatric and Metabolic Institute, Brooklyn, NY, USA.
Alan A SaberDepartment of Surgery, Newark Beth Israel Medical Center, Newark, NJ, USA.
C Anthony HowardDepartment of Surgery, College of Medicine, University of Oklahoma, 4502 E 41st Street, Tulsa, OK, 74135, USA.
Goodarz DanaeiDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Guido M SclabasDepartment of Surgery, College of Medicine, University of Oklahoma, 4502 E 41st Street, Tulsa, OK, 74135, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBariatric surgery improves type 2 diabetes (T2D) in obese patients. The sustainability of these effects and the long-term results have been under question.

objectiveTo compare bariatric surgery versus medical management (MM) for T2D based on a meta-analysis of randomized controlled trials (RCTs) with 2 years of follow-up. MATERIAL AND

methodsSeven RCTs with at least 2-year follow-up were identified. The primary endpoint was remission of T2D (full or partial). Four hundred sixty-three patients with T2D and body mass index > 25 kg/m

resultsAfter 2 years, T2D remission was observed in 138 of 263 patients (52.5%) with bariatric surgery compared to seven of 200 patients (3.5%) with MM (risk ratio (RR) = 10, 95% CI 5.5-17.9, p < 0.001). Subgroup analysis of the Roux-en-Y gastric bypass (RYGB) showed a significant effect size at 2 years in favor of RYGB over MM for a higher decrease of HbA1C (0.9 percentage points, 95% CI 0.6-1.1, p < 0.001), decrease of fasting blood glucose (35.3 mg/dl, 95% CI 13.3-57.3, p = 0.002), increase of high-density lipoprotein (HDL) (12.2 mg/dl, 95% CI 7.6-16.8, p < 0.001), and decrease of triglycerides (32.4 mg/dl, 95% CI 4.5-60.3, p = 0.02). Four studies followed patients up to 5 years and showed 62 of 225 patients (27.5%) with remission after surgery, compared to six of 156 patients (3.8%) with MM (RR = 6, 95% CI 2.7-13, p < 0.001).

conclusionThis meta-analysis shows a superior and persistent effect of bariatric surgery versus MM for inducement of remission of T2D. This benefit of bariatric surgery was significant at 2 years and superior to MM even after 5 years. Compared with MM, patients with RYGB had better glycemic control and improved levels of HDL and triglycerides.

Indexed as

Bariatric SurgeryDiabetes Mellitus, Type 2HumansObesityObesity, MorbidRandomized Controlled Trials as TopicTreatment OutcomeBariatric surgeryMedical managementObesityRandomized controlled trialTreatment outcomeType 2 diabetes mellitus

Identifiers

PMID30402804

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.