Efficacy of metabolic surgery on hba1c decrease in type 2 diabetes mellitus patients with BMI 35 kg/m2 - A review

摘要

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.