Type 2 Remission Linked to Weight Loss After Bariatric Surgery

The chances of achieving remission of type 2 diabetes after a common form of bariatric (weight-loss) surgery increase with greater weight loss up to 20% of body weight, according to a new study published in the journal Diabetes Care.

Bariatric surgery — also known as metabolic surgery in the context of diabetes — involves reducing the size or changing the shape of the stomach to induce weight loss. It has been shown to lead to remission of type 2 diabetes — the absence of signs of diabetes, without taking any glucose-lowering medications — in a large proportion of eligible people who undergo at least some forms of the surgery. But not everyone who undergoes bariatric surgery experiences diabetes remission, and researchers are interested in what factors make remission more or less likely.

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For the latest study, researchers were interested in how much weight loss is typically needed to experience diabetes remission following bariatric surgery. They looked at a group of 5,928 people who had the procedure done — 73% of these participants were female, and the average age of all participants was 49.8 years. The average body-mass index (a measure of body weight that takes height into account) was 43.8, indicating severe obesity. Most participants — 57% — underwent a form of bariatric surgery called Roux-en-Y gastric bypass, while the rest underwent different forms of the surgery.

Factors linked to type 2 remission

During an average follow-up period of 5.9 years, 71% of participants experienced initial diabetes remission. The average duration between surgery and initial remission was 1.0 years. Compared with participants who lost between 0% and 5% of their body weight, those whose weight loss fell in every higher 5% increment — 5% to 10% of body weight, and so on — were more likely to experience diabetes remission up to 20% of body weight. Beyond this point, the likelihood of remission stayed pretty much the same. But the researchers found that even if they were using insulin to treat their diabetes at the time of surgery — which makes remission less likely — participants who lost at least 20% of their body weight were more likely to experience remission than those who lost only 0% to 5% of their body weight.

The researchers concluded that weight loss following bariatric surgery was strongly associated with remission of type 2 diabetes, but that it typically takes about a year to experience this remission. More studies are needed to explore why some people lose more weight than others following bariatric surgery, and how this process is linked to diabetes remission.

Want to learn more about type 2 diabetes remission? Read “Type 2 Diabetes Remission — Can It Be Done?” and “Diabetes ‘Remission’ Is Best Term for Glucose Levels, Report Says.” 

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