Abstract
Introduction: There is an increasing awareness of morbidity-based indications for bariatric surgery, literature on bariatric surgery and diabetes is scarce. Aim: We aimed to assess the bariatric surgery role in diabetes remission and HbA1c reduction. Methods: We systematically searched three databases Pub Med, Cochrane Library and Google Scholar from the first published article up to September 2022. Two reviewers searched the databases using the following keywords: Diabetes remission, HbA1c level, glycated hemoglobin, glycemic control, Bariatric surgery, sleeve gastrectomy and Roux-en-Y gastric bypass. The retrieved data were entered in a datasheet detailing the author's name, year and country of publication, the methodology and HbA1c levels before and after surgery and diabetes remission. The data were analyzed using the most recent RevMan. Results: Out of the 12 studies included in the final meta analysis, five studies on bariatric surgery effect on the glycated hemoglobin (5257 events) showed a reduction of the glycated hemoglobin (odd ratio,-1.05, 95% CI,-1.15-0.96). A substantial heterogeneity was observed, (I2=79%, Pvalue=0.0007) the P-value for the overall effect<0.001. Regarding the complete resolution of diabetes mellitus, we pooled seven studies and found a complete resolution of diabetes mellitus following bariatric surgery (odd ratio, 29.25, 95% CI, 10.92-78.43). No heterogeneity was observed, (I2=0%, P-value=0.63). The P-value for overall effect<0.001 and the chi-square=4.32 with a mean difference of 6. Conclusion: Bariatric surgery was effective in diabetes remission and improving HbA1c. Further studies comparing different types of bariatric surgery regarding the same are needed.