Type 2 diabetes remission following a comprehensive metabolic program including surgery in adults with BMI ≥50 kg/m2 versus BMI <50 kg/m2
In brief
At 12 months, diabetes remission was 67% vs 38% after metabolic surgery
In this cohort, 66.7% of patients with BMI at least 50 achieved complete diabetes remission 12 months after surgery, compared with 37.8% of those with lower BMI. The difference was no longer significant after accounting for factors including diabetes duration and HbA1c, suggesting diabetes severity, not BMI or weight loss, may better explain remission.
- Journal
- Diabetic medicine : a journal of the British Diabetic Association (Q1)
- Published
- 10 October 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Xi May Zhen, Annette Macdonald, Benjamin Woodham, Brendan Ryan, Tien-Ming Hng, Eileene Azar, et al.
- PMID
- 42857893
- DOI
- 10.1111/dme.70453
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 13 October 2026): Diabetes remission after metabolic bariatric surgery
Abstract
AIMS: Previous reports have suggested that higher baseline BMI (bBMI) or %excess weight loss (EWL) are independent predictors of type 2 diabetes mellitus (T2DM) remission after metabolic bariatric surgery (MBS). However, %EWL appears lower in individuals with bBMI ≥50 kg/m2 than those with lower bBMI. Thus, this cohort study aimed to examine T2DM remission after MBS in adults with bBMI <50 kg/m2 versus bBMI ≥50 kg/m2. METHODS: This cohort study included adults with obesity and T2DM who underwent MBS between 01/06/2018 and 31/05/2024 at an Australian tertiary hospital. The primary outcome was complete diabetes remission (HbA1c < 6.0%) at 12 months following MBS. RESULTS: At 12 months following MBS, when compared to those with bBMI <50 kg/m2, a higher proportion of patients with bBMI ≥50 kg/m2 experienced complete diabetes remission (37.8% vs. 66.7%, 95% CI for the difference -48.5% to -6.3%, p = 0.014); this was no longer significant after adjustment for variables such as baseline T2DM duration and HbA1c. The bBMI ≥50 kg/m2 group had greater total weight loss (kg) but lower %EWL, though neither was an independent predictor of remission. CONCLUSIONS: In our cohort, neither bBMI ≥50 kg/m2 nor %EWL appeared as an independent predictor of T2DM remission. The higher proportion with remission (on unadjusted analyses) in those with bBMI ≥50 kg/m2 potentially reflects less advanced diabetes despite greater obesity. Early consideration of MBS may be beneficial given that markers of diabetes duration/severity appeared as potentially important variables associated with T2DM remission.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.