Background: Thirty million people in the United States have diabetes, of which, nearly 90% are considered overweight or obese. Bariatric surgery, with the two most popular types being sleeve gastrectomy (SG) and gastric bypass (GB), is currently indicated as a treatment of type 2 diabetes (T2D) in those with a BMI > 35. However, recent studies have shown bariatric surgery to be an effective treatment in those with BMI < 35. Therefore, the aim of this systematic review was to determine if SG is comparable to GB for treating T2D in those with a BMI < 35.
Methods: An exhaustive literature search was completed using the following search engines: CINAHL-EBSCOhost, Web of Science, and MEDLINE-PubMed, and the following search terms: bariatric surgery, type 2 diabetes, and BMI < 35. The quality of relevant articles was assessed using the GRADE Working Group guidelines.
Results: A total of 2 studies met specific inclusion criteria and were included in this systematic review. Both studies were randomized controlled trials. One study of 60 overweight or non-morbidly obese adults with T2D found GB to be superior to SG in regards to treating T2D. The other study consisted of 64 overweight or non-morbidly obese adults with T2D and found that there was no significant difference in the remission or improvement of T2D between SG and GB.
Conclusion: Whether GB is superior to SG remains unclear; however, SG may be a reasonable alternative to GB. Other studies with larger sample sizes, longer follow-ups, and the use of non-surrogate outcomes are needed to elucidate the differences in SG and GB for treating T2D in those with a BMI < 35.
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