Weight-loss surgery may lead to long-lasting remission of type 2 diabetes

People with type 2 diabetes were far more likely to achieve remission after weight-loss surgery than after intensive medical treatment and lifestyle support.

In a long-term study, 58% of participants assigned to surgery reached remission, compared with 3% of those who received medical and lifestyle care.

Remission means blood sugar drops below the diabetes range without medication to control it. It can last for years, although diabetes may return. Researchers examined both the people who reached remission and those who later relapsed.

The analysis, published in Diabetes Care, included 262 people: 166 assigned to surgery and 96 assigned to medical and lifestyle treatment. Half were followed for at least 11 years, and some were tracked for as long as 14 years.

To be considered in remission, a person had to have an A1C below 6.5% without taking blood sugar medicine. A1C is a blood test that reflects average blood sugar over about three months.

People who had diabetes for fewer years were more likely to go into remission. The same was true for those who had not used insulin and those who had taken fewer types of diabetes medication before the study.

Greater weight loss in the first year was also associated with a higher chance of remission. But that does not mean weight loss alone explains the outcome. The study compared full treatment approaches, each of which can affect blood sugar in several ways.

Among participants who did enter remission, diabetes was more likely to return in those who had lived with the disease longer or had previously used more kinds of blood sugar medicine. These are group-level patterns and cannot predict how long remission will last for any one person.

The 58% figure refers to people who reached remission at some point during follow-up. It does not mean all of them stayed in remission for 14 years. That difference matters, because reaching a blood sugar target and maintaining it over time are not the same thing.

The results give clinicians and researchers more detail about what may happen years after surgery. They also suggest that a person’s diabetes history can matter as much as the early response when judging whether remission is likely to last.

If you are interested in this topic, please read articles about Weight Loss Surgery Helps People with Obesity and Diabetes Live Longer, and Surgery or Weight Loss Drugs a 10 Year Study Reveals Which Helps People with Diabetes Live Longer.

For more information, please see articles about Weight Loss Treatments May Lower Cancer Risk in People with Obesity and Diabetes, and Why Blood Sugar Control Matters More Than Weight Loss in Preventing Diabetes.