Long-Term Effects of Bariatric Surgery on Type 2 Diabetes Control

Background

Bariatric surgery (BS), also known as metabolic surgery or weight loss surgery, has the ability to
treat expressly diabetes, among patients that are mildly obese or merely overweight.
Type 2 Diabetes Mellitus (T2DM), common metabolic condition, is caused both by the defective
insulin secretion by pancreatic ß-cells and the inability of insulin-sensitive tissues to respond
effectively to insulin. Aim of this review is to learn if T2DM can have a long-term remission
after BS, as well as the morbidity and mortality post-BS.

Materials and Methods

Original researches published between 2017 and 2021 were extracted to analyse outcomes of BS
to treat T2DM patients with a Body Mass Index (BMI) less or greater than 35 kg/m2.

Results

A recent meta-analysis of all published studies reporting on T2DM remission after BS (in which
there were included 94,579 surgical patients) shows that remission rates were equivalent in the
60 researches with the mean baseline BMI ≥ 35 kg/m2 (71% cases), in addition 34 studies
including participants with a BMI <35 kg/m2 (72% cases). Moreover, five studies reveal a
decrease in all-cause mortality in patients that have undergone BS. Patients’ results consist of
noticeable improvements in body weight, all glycemic measures, HDL and triacylglycerol levels,
quality of life and overall medication use. Furthermore, most common long-term complications
noted of BS include deficiency of iron (45-52%), vitamin B12 (8-37%), vitamin D (51%),
calcium (10%), as well as anemia and re-operation.

Conclusions

BS has become an effective option in glycemic control in individuals with T2DM and obesity, as
it is recommended for subjects with a BMI over 35 kg/m2 or between 30-35 kg/m2 with obesity-
related comorbidities.

Keywords

Type 2 Diabetes mellitus, Bariatric Surgery, BMI loss