Diabetes remission of bariatric surgery and nonsurgical treatments in type 2 diabetes patients who failure to meet the criteria for surgery: a systematic review and meta-analysis

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Abstract
Background: The efficacy of bariatric surgery in moderate and severe obesity patients to reach diabetes remission is clear, but for mild obesity patients, the choice of surgical and non-surgical treatment is still unclear. This study we aim to compare the effect of surgical and nonsurgical treatment on patients BMI < 35 kg/m2 to reach diabetes remission. Method: We searched relevant articles publish between Jan 1,2010 and Jan 1, 2023 in the following databases: Embase, PubMed/MEDLINE, Scopus, and Cochrane Library. We got the OR, MD and P-value using random effect model to compare the efficiency between bariatric surgery and nonsurgical treatment on diabetes remission, the reduction of BMI, Hb1Ac and FPG. Results: In 7 included studies including 544 participants, bariatric surgery is more effective than non-surgical treatment to reach diabetes remission [OR 25.06, 95%CL 9.58–65.54]. Bariatric surgery more likely resulted in significant reductions in HbA1c [MD -1.44, 95%CL (-1.84)-(-1.04)] and FPG [MD -2.61, 95%CL (-3.20)-(-2.20)]. Bariatric surgery may resulted in reductions in BMI [MD -3.14, 95%CL (-4.41)-(-1.88)], which more significant in Asian. Conclusion: In type 2 diabetes patients who BMI < 35 kg/m2, bariatric surgery is more likely to achieve diabetes remission and better blood glucose control than nonsurgical treatment.

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