Glycemic Status Following Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass in Patients Without Diabetes: A Systematic Review and Meta-Analysis

Abstract

Purpose:

In this meta-analysis, we aim to compare the changes in glycemic status of patients without diabetes undergoing sleeve gastrectomy (SG) versus Roux-en-Y Gastric Bypass (RYGB) and the incidence of postoperative hypoglycemia.

Methods:

We included studies from Medline and CENTRAL databases from inception until October 2021 and extracted glycemic outcome values at their furthest follow-up time. The number of participants was 687 from 6 studies.

Results:

The results revealed no significant difference between patients who underwent RYGB and SG in the means of hemoglobin A1c (HbA1c; 95% confidence interval [CI]: −0.07 to 0.11) and fasting glucose (95% CI: −0.12 to 0.02). A significant difference was observed in the means of body mass index (95% CI: 0.66–2.37), fasting insulin (95% CI: 0.92–2.41), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (95% CI: 0.15–0.50) as these measures were lower following RYGB. The pooled prevalence of hypoglycemia was 36% (95% CI: 31–41).

Conclusion:

There was no significant difference in HbA1c and fasting glucose between the two procedures. However, RYGB led to lower insulin levels and HOMA-IR scores.