ROUX-EN-Y Gastric Bypass (BGYR) versus Sleeve Gastrectomy (GMV) in long-term remission of type 2 Diabetes: a meta-analysis of randomized studies

Introduction: As a treatment measure for obesity, bariatric surgery using Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VMS) has shown promising results in glycemic control and reduction of comorbidities. However, there are few long-term follow-up studies comparing the two techniques in obese and diabetic patients. Objective: To compare long-term diabetes remission using RYGB or VGM in patients who have undergone bariatric surgery in the last ten years. Method: Systematic review and meta-analysis carried out according to the Preferred Reporting Items for Meta-analysis protocol. An advanced search strategy was applied to Pubmed, Embase and Web of Science to select randomized clinical trials comparing RYGB and VGM in diabetes remission. The mean difference (MD) and odds ratio (OR) were calculated for binary outcomes by statistical analysis using Review Manager 5.4 software with the use of subgroups. Results: 5 randomized studies and 337 patients were included, showing that long-term remission of type 2 diabetes mellitus was higher for patients undergoing RYGB (OR 1.84; 95% CI 1.13-3.00; P-value = 0.01; I2= 0%), especially at the 5-year follow-up interval (OR 2.41; 95% CI 1.32-4.39; P-value = 0.004; I2= 0%). Conclusion: Roux-en-Y gastric bypass (RYGB) resulted in a higher remission rate of type 2 diabetes mellitus compared to vertical sleeve gastrectomy (VMS) in the long term.