Patients with prediabetes and severe obesity who underwent metabolic surgery, such as Roux-en-Y gastric bypass or sleeve gastrectomy, had a significantly reduced risk of developing type 2 diabetes over a 15-year period compared with patients who did not have surgery.
Metabolic surgery significantly reduces the risk of developing type 2 diabetes in severely obese patients with prediabetes, providing both treatment and prevention benefits. Patients who underwent surgery such as gastric bypass experienced a significant reduction in diabetes incidence and maintained significant weight loss.
Patients with prediabetes and severe obesity who underwent metabolic and bariatric surgery were 20 times less likely to develop full-blown type 2 diabetes over a 15-year period than patients who did not undergo surgery. This is according to a new study titled “Long-Term (15-Year) Impact of Bariatric Surgery on Conversion of Prediabetes to Type 2 Diabetes,” being presented today (June 11) at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Session.
Long-term benefits of bariatric surgery
Only 1.8% of patients were diagnosed with diabetes within 5 years after metabolic surgery (Roux-en-Y gastric bypass or sleeve gastrectomy), but this rose to 3.3% after 10 years and 6.7% after 15 years. The preventive effect against diabetes was greater in patients who had gastric bypass surgery.
In contrast, about one-third (31.1%) of patients who had not undergone metabolic surgery progressed from prediabetes to diabetes within five years, increasing to 51.5% and 68.7% at 10 and 15 years, respectively. Patients lost an average of 29.4% of their body weight at 12 months and 27.6% at 36 months. The greater the weight loss at three years, the lower the risk of progression to diabetes.
The significant impact of surgery on prediabetes
“This is the first study to analyze the long-term effects of metabolic and bariatric surgery on the potential progression of prediabetes, and the impact is significant and lasting,” said study co-author David Parker, MD, a bariatric surgeon at Geisinger Medical Center in Danville, Pa. “Metabolic surgery has been demonstrated to be both a prevention and a treatment for diabetes.”
Prevalence of Prediabetes and Diabetes in the United States
Prediabetes is a serious condition that occurs when blood sugar levels are higher than normal but not high enough to be considered type 2 diabetes. According to the CDC, approximately 98 million Americans (more than 1 in 3) have prediabetes and 38.4 million have diabetes.
Study design and demographics
This retrospective study included 1,326 patients who were prediabetic before undergoing Roux-en-Y gastric bypass (n=1,154) or sleeve gastrectomy (n=172) between 2001 and 2022. Nonsurgical controls from the primary care cohort were propensity matched by hemoglobin A1c, age, sex, and body mass index (BMI). More than 80% of patients were female, with a mean age of 45 years, mean BMI of 46.9, and a median follow-up of 7.2 years.
“Think of the adverse health effects that metabolic surgery could potentially avoid for people with diabetes,” said ASMBS president Marina Kurian, M.D., who was not involved in the study. “Preventing diabetes is the best treatment.”
ASMBS Report on Surgery Rates and Obesity
The ASMBS reports that approximately 280,000 metabolic and obesity treatment procedures were performed in 2022, which represents only about 1% of those who met the eligibility requirements based on BMI. According to the Centers for Disease Control and Prevention (CDC), obesity affects 42.4% of Americans. Research has shown that obesity can weaken or impair the body’s immune system, cause chronic inflammation, and increase the risk of many other diseases and conditions. Cardiovascular diseasestroke, type 2 diabetes, and certain cancers.
About Weight Loss Surgery
Metabolic, bariatric, or weight loss surgeries, such as gastric bypass and sleeve gastrectomy, have proven to be the most effective, long-term treatments for severe obesity. These surgeries reverse or reverse diseases such as type 2 diabetes, heart disease, and high blood pressure, and result in significant and permanent weight loss. Their safety profile is comparable to some of the safest and most commonly performed surgeries in the United States, such as gallbladder surgery, appendectomy, and knee replacement.
