Five-Year Outcomes of Sleeve Gastrectomy with Transit Bipartition in Women with Severe Obesity and Insulin-Treated Type 2 Diabetes: A Prospective Single-Center Cohort Study of 35 Women
In brief
Five years after surgery, 66% of 35 women had medication-free diabetes remission
In this single-center cohort of women with severe obesity and insulin-treated type 2 diabetes, average weight fell 35.7% over five years; 23 of 35 women met the study's definition of medication-free remission. But 90% had at least one measured biochemical abnormality, including low vitamin D in 73%, underscoring the need for lifelong nutritional and metabolic follow-up.
- Journal
- Obesity surgery (Q1)
- Published
- 12 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 4, Very Low (CEBM 4)
- Authors
- Tuna Bilecik
- PMID
- 42862453
- DOI
- 10.1007/s11695-026-08981-y
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 18 October 2026): Five-year weight loss and glycemic improvement after SG+TB
Abstract
INTRODUCTION: Five-year data on metabolic durability, nutritional outcomes, and late morbidity after sleeve gastrectomy with transit bipartition (SG + TB) remain limited. We evaluated glycemic, weight, nutritional, and safety outcomes in women with severe obesity and insulin-treated type 2 diabetes mellitus (T2DM). METHODS: This prospective single-center follow-up included 35 women who underwent laparoscopic SG + TB in 2016-2017. At 5 years, 30/35 (85.7%) retained SG + TB anatomy and had complete efficacy data; weight and HbA1c were available in one additional revised patient (31/35, 88.6%). T2DM remission was defined as HbA1c < 6.5% at least 3 months after stopping glucose-lowering pharmacotherapy. Nutritional assessment used a prespecified limited biochemical panel. RESULTS: In the 30-patient anatomy-retained complete-case cohort, mean HbA1c decreased from 9.2 ± 1.0% to 5.5 ± 0.7%, body weight from 118.0 ± 10.6 to 75.6 ± 6.8 kg, and mean total weight loss was 35.7 ± 5.1%. Medication-free T2DM remission was 23/30 (76.7%; 95% CI, 59.1-88.2%); the conservative all-enrolled estimate was 23/35 (65.7%; 95% CI, 49.2-79.2%). At year 5, hypoalbuminemia was 20.0%, low serum iron 30.0%, vitamin B12 deficiency 13.3%, and vitamin D deficiency 73.3%; 27/30 (90.0%) had at least one predefined biochemical abnormality. Two patients required an SG + TB-related invasive intervention, including one revision; two additional patients underwent laparoscopic cholecystectomy. CONCLUSION: SG + TB was associated with substantial 5-year weight loss and glycemic improvement, but the lower all-enrolled remission estimate highlights attrition and revision-related exclusion. Biochemical abnormalities and clinically important gastrointestinal morbidity show that preserved duodenal continuity does not eliminate potential hypoabsorptive consequences. Lifelong metabolic and nutritional surveillance is warranted.
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.