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CLINICAL OUTCOMES OF INTENSIVE MEDICAL TREATMENT VS SLEEVE GASTRECTOMY FOR DIABETES IN MORBID OBESITY- A META-ANALYSIS OF THE LITERATURE

Chike Okolocha1, Leo Larios1, Sitembile Lee1, Aliu Sanni, MD, FACS2. 1Philadelphia College of Osteopathic Medicine – Georgia Campus, 2Eastside Bariatric and General Surgery

INTRODUCTION: Diabetes and obesity are known to have a strong correlation as about 90% of type II diabetics are obese. Studies have shown that bariatric surgery in the obese result in optimal glycemic control, reduction of co-morbidities, and often even superior when compared to Intensive Medical Treatment (IMT) in the treatment of diabetes. The aim of this review is to evaluate the outcomes of laparoscopic sleeve gastrectomy (LSG) as it compares to IMT for the treatment of DM in morbid obesity.

METHODS: A systematic review was conducted through PubMed to identify relevant publications from 2012 to 2016 with comparative studies on LSG and IMT for management of diabetes in morbid obesity. The outcomes analysed included Haemoglobin A1c (HbA1c), Body Mass Index (BMI) reduction and Fasting Plasma Glucose (FPG) mg/dL. Results are expressed as standard difference in means with standard error. Statistical analysis was done using fixed-effects meta-analysis to compare the mean value of the two groups. (Comprehensive Meta-Analysis Version 3.3.070 software; Biostat Inc., Englewood, NJ).

RESULTS: Three out of 24 studies were quantitatively assessed and included for this meta-analysis. A total of 53 patients underwent LSG and 56 patients IMT for the control of diabetes.  HbA1c (-0.77 ± 0.20; p<0.05), BMI reduction (-1.72 ± 0.23; p<0.05) and FPG (-1.384 ±0.25; p<0.05) were all significantly lower in the LSG group when compared to the IMT group.

CONCLUSION: Laparoscopic sleeve gastrectomy is more effective in the management of diabetes in morbid obesity when compared to intensive medical treatment. 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86705

Program Number: P609

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

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