Observational studyActa diabetologica2026
Metabolic heterogeneity after laparoscopic sleeve gastrectomy in type 2 diabetes mellitus patients with severe obesity: insights from continuous glucose monitoring, glycemic profiles and quality of life.
Observational study in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
Funding
Abstract
backgroundSleeve gastrectomy (SG) induces substantial metabolic improvement in patients with type 2 diabetes (T2DM), but glycemic remission remains heterogeneous. We evaluated metabolic, continuous glucose monitoring (CGM), and quality-of-life (QoL) outcomes after SG according to remission status.
methodsProspective observational study of patients with severe obesity and T2DM undergoing SG that were evaluated preoperatively and at 12 months. Patients were analyzed in T2DM remission (RG) and persistent diabetes (PG) groups.
resultsRG included 15, while PG 18 patients. Weight loss and excess BMI loss were comparable between groups. RG demonstrated greater improvement in fasting glucose and HOMA-IR at follow-up, while HOMA-B decreased significantly in RG but increased in PG, suggesting divergent β-cell adaptation. CGM showed significant postoperative improvement in both groups, with consistently lower mean glucose and fewer hyperglycemic readings in RG. Hypoglycemia indices increased in both groups. QoL improved substantially across BAROS and SF-36 domains, with more pronounced physical improvements; between-group differences in QoL were modest despite distinct metabolic trajectories.
conclusionsSG provided meaningful metabolic and quality-of-life benefits, particularly in patients achieving remission, suggesting potential benefits of earlier surgical referral before advanced β-cell deterioration limits the potential for metabolic recovery, and highlighting the value of CGM for individualized postoperative de-escalation of therapy.
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Registered trials
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