Remission and relapse of diabetes after sleeve gastrectomy and one‐anastomosis gastric bypass: The Tehran Obesity Treatment Study
Authors' conclusion
After 5 years of follow-up, there were no significant differences between the SG and OAGB groups with regard to T2DM remission and relapse. Bariatric surgery was less likely to result in remission in patients with a history of insulin therapy and longer durations of T2DM prior to surgery. Furthermore, patients who received ≥2 glucose-lowering agents, despite possible remission, were at a higher risk of experiencing late relapse.
Study context
- Population
- Patients with T2DM and obesity (BMI ≥ 30.0 kg/m²) undergoing sleeve gastrectomy (SG) or one-anastomosis gastric bypass (OAGB), March 2013–March 2021; 82.5% female (Tehran Obesity Treatment Study)
- Participants
- 891 patients
- Exposure
- SG vs OAGB
- Outcome
- T2DM remission (HbA1c < 48 mmol/mol and fasting plasma glucose (FPG) <7 mmol/L, off glucose-lowering agents/insulin) and relapse (FPG ≥7 mmol/L or HbA1c ≥48 mmol/mol, or need for pharmacotherapy)
- Follow-up
- 5 years
Methodological details5 years of follow-up
- 5 years of follow-up
Main finding
As reported in the abstract
Overall T2DM remission rate
61.4 per 1000 person-months (95% CI 56.8-66.4)
Overall T2DM relapse rate
5.7 per 1000 person-months (95% CI 4.1-7.9)
Observational data: associations, not effects.
Further findings
Predictors of remission and relapse
- History of insulin therapy and T2DM duration before surgery predicted remission (multivariate HR analysis)
- Treatment with ≥2 glucose-lowering agents was the only relapse predictor
Time to remission or relapse
- Significantly shorter time to remission or relapse with SG vs OAGB
Original publication
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