Globally, the incidence of obesity and type 2 diabetes continues to rise. The two diseases often go hand in hand and interact, posing a serious health challenge. Fortunately, as we gain a deeper understanding of the interrelationship between these two diseases, metabolic and bariatric surgery has proven to be an effective treatment modality that not only helps with weight loss, but also significantly improves blood sugar control in patients with obesity and T2DM. But the key is not just short-term weight loss and blood sugar drops
But more importantly achieving long-term disease control and remission. A recent 10-year follow-up study published in the journal ObesitySurgery provides important clinical data on long-term diabetes remission after MBS.
MBS can effectively improve blood glucose control in diabetic patients and alleviate T2DM in obese patients. A meta-study showed that 78% of T2DM patients had remission after receiving MBS, and 87% had improvement. Moderate weight loss can improve diabetes and reduce the need for hypoglycemic drugs, while greater weight loss can significantly reduce HbA1c and fasting blood glucose and promote sustained remission of diabetes for at least 2 years.
According to authoritative recommendations, MBS should be recommended for T2DM adults with body mass index (BMI) ≥30kg/㎡ as a weight and blood glucose management method. Preoperative variables such as youth, short duration of diabetes, and absence of insulin therapy were associated with the likelihood of complete remission. Lower preoperative fasting glucose and HbA1c levels, as well as higher C-peptide levels and improved pancreatic beta cell function were also predictors of T2DM remission after MBS.
Although studies have supported remission of diabetes after MBS, the long-term effects are unclear. The aim of this study was to determine the rates of sustained remission and recurrence of T2DM at 10 years after MBS, characterize blood glucose, and identify factors that predict sustained remission.
This study is a long-term follow-up study involving patients with type 2 diabetes who underwent bariatric surgery between 2007 and 2013. Data on baseline characteristics, type of surgery, postoperative glycemic control, and long-term follow-up were collected. The primary endpoint is the long-term response rate, where blood sugar levels remain normal without the use of hypoglycemic drugs.
This was a 10-year retrospective study of obese patients (BMI≥35kg/ ㎡) conducted by a multidisciplinary team on surgical obesity Management. Between 2010 and 2013, a total of 909 patients received MBS, and 427 patients were included in the analysis after gastric band surgery, no follow-up, and information deficiency were excluded.
Only patients with complete baseline data and at least 10 years of follow-up were included, including data on body weight, fasting blood glucose (FBG) or glycated hemoglobin (HbA1c) levels, and diabetes medication status.
A total of 95 patients were included in this study, whose mean age was 48.8±9.08 years, mean body weight and BMI were 114±16.1kg and 44.9±6.39kg/ ㎡, respectively, and average HbA 1c level was 7.0±1.48%. At the time of surgery, 81 patients (94.9%) were receiving antidiabetic drugs, of which 13 patients (13.7%) were receiving insulin.
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