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

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Date
2007
Dewey
Economie sociale
Sujet
weight loss; morbid obesity; type 2 diabetes mellitus; Bariatric surgery; literature review; treatment outcome
JEL code
I.I1.I19; I.I1.I11
Journal issue
Obesity Surgery
Volume
17
Number
9
Publication date
2007
Article pages
1248-1256
Publisher
Rapid Communications of Oxford
DOI
http://dx.doi.org/10.1007/BF02802098
URI
https://basepub.dauphine.fr/handle/123456789/1548
Collections
  • LEDa : Publications
Metadata
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Author
Lévy, Pierre
163511 Laboratoire d'Economie de Dauphine [LEDa]
163517 Laboratoire d'Economie et de Gestion des Organisations de Santé [Legos]
Fried, Martin
101789 ISCARE
Santini, Ferruccio
137302 Department of Endocrinology and Metabolic Diseases
Finer, Nick
207159 Wellcome Trust Clinical Research Facility
Type
Article accepté pour publication ou publié
Abstract (EN)
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.

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