DIABETES REMISSION POST-BARIATRIC SURGERY

A SABAH PERSPECTIVE

Abstract

INTRODUCTION
Bariatric surgery is not only effective for weight loss but also improves obesity-related complications, including inducing diabetes remission. We aimed to investigate the effects of bariatric surgery on diabetes remission in our centre.

METHODOLOGY
We conducted an observational retrospective study of patients with type 2 diabetes who underwent bariatric surgery (Laparoscopic Sleeve Gastrectomy, Laparoscopic Sleeve Gastrectomy with Proximal Jejunal Bypass, Roux-en-y Gastric Bypass or Mini Gastric Bypass) between March 2022 and February 2024 at Queen Elizabeth Hospital 2. We gathered data on the patients’ preoperative weight, body mass index (BMI), HbA1c, antidiabetic medications, diabetes duration, postoperative weight loss and percentage total weight loss (%TWL). Diabetes remission at 1-year post-surgery was defined as having an HbA1c of <6.3% without antidiabetic medications.

RESULT
Thirty-five patients were recruited with mean preoperative weight of 122.0±23.2 kg, BMI of 47.0±7.5 kg/m², HbA1c 7.7±1.7%, and median diabetes duration of 4.38 years (range 0.3–19.9). Average postoperative weight loss at 1 year was 34.7±13.6 kg with mean %TWL of 27.8±7.6%. Diabetes remission was achieved in 17 patients (49%). Factors significantly associated with remission were shorter diabetes duration (median 1.92 years [IQR: 1–4.5], p <0.001) and absence of insulin use (Crude OR 4.8, 95% CI: 1.1–20.1). No significant associations were found for preoperative HbA1c, BMI, type of surgery, or %TWL. Multivariate analysis identified diabetes duration as the sole independent predictor of remission.

CONCLUSION
Our findings support the effectiveness of bariatric surgery in achieving diabetes remission in patients with obesity, aligning with evidence from the STAMPEDE trial and DiaRem score studies. Shorter diabetes duration emerged as the strongest predictor of remission, while the types of surgery were of comparable benefit. Longer-term follow-up is warranted to assess the durability of remission.