Surgery Provides Long-Term Blood Glucose Control, Type 2 Diabetes Remission

People with type 2 diabetes who underwent bariatric surgery achieved better long-term blood glucose control compared to people who received medical management plus lifestyle interventions, according to a new study supported by NIH. 

The participants who underwent bariatric surgery, also called metabolic or weight-loss surgery, were also more likely to stop needing diabetes medications and had higher rates of diabetes remission up to 12 years post-surgery. Results of the study were published in JAMA and funded by NIDDK.

“While there are many factors involved, and not all of them are completely understood, bariatric surgery typically results in greater weight loss that affects a person’s metabolic hormones, which improves the body’s response to insulin and ability to maintain healthy blood glucose levels,” said NIDDK project scientist Dr. Jean Lawrence. “These results show that people with overweight or obesity and type 2 diabetes can make long-term improvements in their health and change the trajectory of their diabetes through surgery.”

The current study is a follow-up that combined data from four independent single-center randomized trials conducted at clinical sites in the United States. The original trials evaluated the effectiveness of bariatric surgery compared to intensive lifestyle and medication therapy involving oral and injectable diabetes medications including insulin, for adults with type 2 diabetes and overweight or obesity. While some participants in the study were prescribed GLP-1 agonists as part of their medical management of diabetes, these drugs were not specifically examined in the study. Investigators from the four individual studies pooled their data to provide a larger and more geographically diverse data set to evaluate efficacy, durability and safety of bariatric surgery to treat type 2 diabetes. 

In total, 262 participants from the four original studies enrolled in the current study. Of these, 166 were randomized to surgery and had undergone one of three bariatric surgery procedures. The remaining 96 participants were randomized to the medical/lifestyle management group. The medical/lifestyle interventions have previously been shown effective for weight loss. 

All participants were between ages 18 and 65 and had overweight or obesity as measured by body mass index, or BMI.