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The Comparative Effects of Bariatric Surgery on Weight and Type 2 Diabetes

Author

Listed:
  • Pierre Lévy

    (LEDa - Laboratoire d'Economie de Dauphine - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres, Legos - Laboratoire d'Economie et de Gestion des Organisations de Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

  • Martin Fried

    (ISCARE - ISCARE)

  • Ferruccio Santini

    (Department of Endocrinology and Metabolic Diseases - LUMC - Leiden University Medical Center - Universiteit Leiden = Leiden University)

  • Nick Finer

    (Wellcome Trust Clinical Research Facility - Birmingham Children's Hospital)

Abstract

Background: Epidemiological evidence confirms that risk of developing type 2 diabetes is related to weight gain. Weight reduction is beneficial as relative risk is reduced to 0.13 for weight loss >20 kg. This raises the question of effectiveness of bariatric surgery on 1) weight loss and 2) diabetes-related outcomes in morbidly obese patients.Methods: We reviewed the literature using Medline. Only 2 meta-analyses reporting on both outcomes were included, as well as 50 systematic reviews or primary studies.Results: Meta-analyses mainly based on case series data as well as controlled studies confirm that bariatric surgery is highly effective in obtaining weight reduction in morbidly obese patients up to 60% of the excess weight, along with resolution of preoperative diabetes in more than 75% of cases. Among bariatric surgery techniques, malabsorptive procedures (biliopancreatic diversion and gastric bypass) appear to be more effective on both outcomes than restrictive procedures (gastroplasty and gastric banding).Conclusion: Even if more studies are needed to confirm current evidence, bariatric surgery is effective for controlling diabetes. It appears as an efficient strategy from economic modeling due to savings from reduction in diabetes-related costs.

Suggested Citation

  • Pierre Lévy & Martin Fried & Ferruccio Santini & Nick Finer, 2007. "The Comparative Effects of Bariatric Surgery on Weight and Type 2 Diabetes," Post-Print hal-01293732, HAL.
    • Handle: RePEc:hal:journl:hal-01293732
    DOI: 10.1007/BF02802098
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    Cited by:

    1. Bruce Wang & Edwin Wong & Rafael Alfonso-Cristancho & Hao He & David Flum & David Arterburn & Louis Garrison & Sean Sullivan, 2014. "Cost-effectiveness of bariatric surgical procedures for the treatment of severe obesity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(3), pages 253-263, April.

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