Coleman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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A 20% weight-loss threshold after bariatric surgery is associated with initial type 2 diabetes remission, even among patients with a high BMI using insulin, data from a records review show.
In an analysis of electronic health records within the Kaiser Permanente Southern California health care system, researchers found that weight loss after bariatric surgery is strongly associated with initial type 2 diabetes remission; however, rates of initial diabetes remission did not increase substantially above a threshold of 20% total weight loss.
Each 5% of body weight lost after bariatric surgery is associated with greater odds for diabetes remission. Data were derived from Barthold D, et al. Diabetes Care. 2021;doi:10.2337/dc21-0714.
“Even if patients with diabetes have conditions at surgery that make it hard for them to benefit fully from the intervention, like a BMI of 50 kg/m2 or more and being on insulin, they still derive similar benefits for their diabetes from surgery as people who do not have these conditions as long as they lose 20% of their body weight,” Karen J. Coleman, PhD, MS, a research scientist in the division of health services research at Kaiser Permanente Southern California, told Healio.
Karen J. Coleman
Coleman and colleagues analyzed EHR data from 5,928 patients with type 2 diabetes who underwent sleeve gastrectomy (n = 2,546) or Roux-en-Y gastric bypass surgery (n = 3,382) between 2009 and 2016 (mean age, 50 years; 73% women; mean baseline BMI, 43.8 kg/m2). The primary outcome was type 2 diabetes remission, determined at least 90 days after surgery or stopping all diabetes medication. Researchers used Cox proportional hazards models to assess the relationship between initial type 2 diabetes remission and percent total weight loss after bariatric surgery, with categories of percentage of total weight loss included in the model as time-varying covariates.
During a mean 5.9 years of follow-up, 71% of patients experienced initial remission of type 2 diabetes, with a mean time to remission of 1 year.
With 0% to 5% total weight loss used as the reference group, researchers found patients were more likely to remit with each 5% increase in total weight loss until 20% total weight loss, with an HR range of 1.97 to 2.92.