The Effect and Outcomes of Metabolic Surgery in Pediatric Patients with Type 2 Diabetes Mellitus: A Systematic Review

Type Two Diabetes Mellitus (T2DM), formerly known as adult-onset diabetes, is a disease caused by impaired pancreatic insulin production and the ineffective use of insulin (insulin resistance) in the liver and periphery. It is believed that today, up to 5000 children are being diagnosed with Type Two Diabetes Mellitus per year, with the incidence of T2DM tripling between the ages of 10-14 and 15-18, especially among racial minorities. A high-yield symptom for those suffering from T2DM is weight gain, however, T2DM can also be linked to other co-morbidities including hypertension, dyslipidaemia, diabetic retinopathy, nephropathy, and neuropathy. This is why the American Diabetes Association introduced bariatric surgery as a form of diabetic treatment in 2009. Since its approval, bariatric surgical procedures such as Gastric Banding (GB), Roux-en-Y Gastric Bypass (RYGB), Biliopancreatic Diversion (BPD), and Sleeve Gastrectomy (SG) have elicited several positive results in adult patients. However, its use on children has been put into question due to safety concerns. For that reason, we searched databases such as PubMed, ScienceDirect, Cochrane Library, Embase, and Google Scholar to conduct a systematic review containing 34528 patients from 20 different studies to determine the effectiveness of bariatric surgery as a treatment option for obese pediatric patients with Type Two Diabetes Mellitus. For this systematic review, we only included patients <18 years of age with a BMI >35 along with papers that measured their patients' change in Body Mass Index (BMI), estimated weight loss (EWL), or total weight loss (TWL). Upon completion of the investigation, it was concluded that bariatric surgery is an effective treatment for obese adolescents with Type Two Diabetes Mellitus.