ArticleObesity facts2026
Determinants of Diabetes Remission and Relapse following Sleeve Gastrectomy and Gastric Bypass: A 2- and 5-Year Follow-Up Study.
Article in Obesity facts, 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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Abstract
introductionBariatric surgery is an established treatment for obesity and has been shown to improve glycaemic control and frequently induces remission of type 2 diabetes mellitus (T2DM). However, the long-term sustainability of remission remains uncertain as relapse may occur over time. This study evaluated short- and long-term remission rates and identified factors associated with remission durability and relapse.
methodsA retrospective cohort study was conducted, which included 186 patients with obesity and type2 diabetes who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass between January 2009 and December 2020 at University Hospital Ayr. Diabetes remission was defined as HbA1c <6.0% without anti-diabetic medication use, assessed at 2 years (short term) and 5 years (long term). Multivariable logistic and Cox regression models were used to identify factors associated with remission and relapse.
resultsTwo- and 5-year post-surgery remission rates were 57.5% and 36.4%, respectively. Shorter duration of diabetes (OR 0.86, 95% CI 0.76-0.96; p = 0.009), lower preoperative HbA1c (OR 0.61, 95% CI 0.43-0.87; p = 0.005), and not using anti-diabetic medications before surgery (p < 0.05) were all associated with a higher likelihood of diabetes remission at 2 years. Of 107 patients who achieved remission at 2 years, 33.4% experienced diabetes relapse by 5 years. Age (HR 1.06; 95% CI 1.01-1.12; p < 0.015) and use of anti-diabetic medications (p < 0.05) were identified as significant factors associated with diabetes relapse.
conclusionBariatric surgery is effective in achieving early remission of T2DM; however, one-third of patients experience relapse within 5 years. A more favourable preoperative metabolic profile and younger age play a crucial role in remission durability. These findings highlight the importance of long-term follow-up and individualised patient counselling on expected diabetes outcomes after bariatric surgery.
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