PMID- 29405276
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Linking)
VI  - 105
IP  - 3
DP  - 2018 Feb
TI  - Meta-analysis of metabolic surgery versus medical treatment for microvascular 
      complications in patients with type 2 diabetes mellitus.
PG  - 168-181
LID - 10.1002/bjs.10724 [doi]
AB  - BACKGROUND: This study aimed to examine the effect of metabolic surgery on 
      pre-existing and future microvascular complications in patients with type 2 
      diabetes mellitus (T2DM) in comparison with medical treatment. Although metabolic 
      surgery is the most effective treatment for obese patients with T2DM regarding 
      glycaemic control, it is unclear whether the incidence or severity of 
      microvascular complications is reduced. METHODS: A systematic literature search 
      was performed in MEDLINE, Embase, Web of Science and the Cochrane Central 
      Register of Controlled Trials (CENTRAL) with no language restrictions, looking 
      for RCTs, case-control trials and cohort studies that assessed the effect of 
      metabolic surgery on the incidence of microvascular diabetic complications 
      compared with medical treatment as control. The study was registered in the 
      International prospective register of systematic reviews (CRD42016042994). 
      RESULTS: The literature search yielded 1559 articles. Ten studies (3 RCTs, 7 
      controlled clinical trials) investigating 17 532 patients were included. 
      Metabolic surgery reduced the incidence of microvascular complications (odds 
      ratio 0.26, 95 per cent c.i. 0.16 to 0.42; P < 0.001) compared with medical 
      treatment. Pre-existing diabetic nephropathy was strongly improved by metabolic 
      surgery versus medical treatment (odds ratio 15.41, 1.28 to 185.46; P = 0.03). 
      CONCLUSION: In patients with T2DM, metabolic surgery prevented the development of 
      microvascular complications better than medical treatment . Metabolic surgery 
      improved pre-existing diabetic nephropathy compared with medical treatment.
CI  - (c) 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.
FAU - Billeter, A T
AU  - Billeter AT
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Scheurlen, K M
AU  - Scheurlen KM
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Probst, P
AU  - Probst P
AUID- ORCID: 0000-0002-0895-4015
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Eichel, S
AU  - Eichel S
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Nickel, F
AU  - Nickel F
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Kopf, S
AU  - Kopf S
AD  - Department of Internal Medicine I and Clinical Chemistry, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Fischer, L
AU  - Fischer L
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Diener, M K
AU  - Diener MK
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Nawroth, P P
AU  - Nawroth PP
AD  - Department of Internal Medicine I and Clinical Chemistry, University of 
      Heidelberg, Heidelberg, Germany.
FAU - Muller-Stich, B P
AU  - Muller-Stich BP
AD  - Department of General, Visceral and Transplantation Surgery, University of 
      Heidelberg, Heidelberg, Germany.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
RN  - 0 (Hypoglycemic Agents)
SB  - IM
CIN - Ann Intern Med. 2018 Jul 17;169(2):JC9. PMID: 30014098
MH  - *Bariatric Surgery
MH  - Diabetes Mellitus, Type 2/*complications/therapy
MH  - Diabetic Angiopathies/epidemiology/etiology/*prevention & control
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Incidence
MH  - Microvessels
MH  - Odds Ratio
MH  - Treatment Outcome
EDAT- 2018/02/07 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/02/07 06:00
PHST- 2017/05/24 00:00 [received]
PHST- 2017/08/27 00:00 [revised]
PHST- 2017/09/12 00:00 [accepted]
PHST- 2018/02/07 06:00 [entrez]
PHST- 2018/02/07 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
AID - 10.1002/bjs.10724 [doi]
PST - ppublish
SO  - Br J Surg. 2018 Feb;105(3):168-181. doi: 10.1002/bjs.10724.