The Impact of Bariatric Surgery on Weight Loss and Glycemic Control in Patients With Obesity and Type 2 Diabetes: A Systematic Review

Abstract

Obesity and type 2 diabetes mellitus (T2DM) are global health challenges. Bariatric surgery has emerged as a potential intervention for managing these conditions, but its efficacy and impact need comprehensive evaluation. This systematic review aimed to assess the impact of bariatric surgery on weight loss and glycemic control in patients with obesity and T2DM. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was conducted in October 2023, primarily using PubMed. Studies were selected based on specific inclusion and exclusion criteria, focusing on bariatric surgery's relationship with weight loss and glycemic control. The quality of the included studies was assessed using the ROBINS-I (risk of bias in non-randomized studies of interventions) risk of bias assessment approach. Out of 272 initially identified studies, nine met the inclusion criteria. These studies, encompassing 10,445 participants from various global locations, predominantly targeted middle-aged participants. The findings consistently highlighted the benefits of bariatric surgery in weight reduction and improved glycemic control. However, the degree of benefits varied based on the type of surgical procedure, patient's BMI, and other individual factors. Bariatric surgery offers significant advantages in managing obesity and T2DM. While it consistently aids in weight reduction and glycemic control, individualized treatment approaches considering various patient and procedural factors are crucial for optimal outcomes. When applied to the right patient, bariatric surgery can offer significantly better glycemic control and weight reduction when compared to only medication control and lifestyle adjustments. However, future research should focus on long-term outcomes and the integration of surgical interventions with lifestyle and medical management.