Mixed
Bariatric surgery is significantly more effective than conventional medical therapy in achieving weight loss, glycemic control, and type 2 diabetes remission in patients with BMI ≥25.
For patients with obesity and Type 2 Diabetes, conventional medical therapy (diet, exercise, medication) often fails to achieve long-term remission, with 50-90% of patients failing to control their diabetes. Bariatric surgery offers a significantly higher chance of remission (63.5% vs 15.6%) and greater weight loss compared to conventional therapy. While surgery is invasive, it addresses the physiological mechanisms of diabetes more effectively than lifestyle changes alone for this population.
In a meta-analysis of 16 studies (5 RCTs) with 6,131 patients and mean 17.3-month follow-up, bariatric surgery was significantly more effective than conventional medical therapy in achieving weight loss, HbA1C and FPG reduction, and diabetes remission.
Why this rating
Meta-analysis of 16 studies including 5 RCTs and observational studies with large sample size (n=6,131), though with significant heterogeneity (I2≥75%).
Source
Diabetes and Weight in Comparative Studies of Bariatric Surgery vs Conventional Medical Therapy: A Systematic Review and Meta-Analysis
G. Ribaric et al. · Obesity Surgery · 2013
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