TOPLINE:

Among patients with type 2 diabetes (T2D) and obesity, laparoscopic one anastomosis gastric bypass (OAGB) achieved high long-term remission rates, substantial weight loss, and durable glycemic control over 10 years.

METHODOLOGY:

• Although OAGB is increasingly recognized as an effective bariatric procedure, long-term data on diabetes remission and metabolic durability remain limited.
• Researchers conducted a retrospective analysis of 127 patients (mean age, 48.2 years; 59% female) with T2D and obesity who underwent OAGB in 2015 at a medical university in Uzbekistan, performed by a single experienced surgical team.
• Eligible patients had T2D for at least 3 years, met BMI criteria for obesity (≥ 35 or 30-34.9 with metabolic complications), had not achieved glycemic control with medical management, and completed at least 10 years of follow-up.
• Of the cohort, 47 patients (37%) were insulin-dependent preoperatively, whereas 80 (63%) were treated with oral agents alone.
• Complete remission was defined as A1c < 6.5% measured at least 3 months after discontinuation of glucose-lowering therapy and sustained for at least 12 months without antidiabetic medications.

TAKEAWAY:

• At 10 years, complete T2D remission was achieved in 94.5% of patients; all insulin-treated patients transitioned to oral agents or discontinued insulin postoperatively, and none required reinitiation.
• Mean A1c decreased from 11.6% preoperatively to 5.9% at 1 year and remained stable at 5.7%-5.8% from years 2 through 10.
• Younger age and shorter diabetes duration were associated with higher remission rates; preoperative C-peptide levels < 2.0 ng/mL were the strongest predictor of non-remission, observed in 85.7% of patients who did not achieve remission.
• At 10 years, mean body weight decreased from 108 kg preoperatively to 72 kg, corresponding to 96.3% excess weight loss and 33.3% total weight loss.
• No perioperative mortality, major complications, or conversions to open surgery were reported.

IN PRACTICE:

“These findings support the role of OAGB as an effective and durable bariatric-metabolic procedure in the surgical management of obesity-related type 2 diabetes mellitus, particularly when performed by experienced surgeons in appropriately selected patients,” the authors of the study wrote.

SOURCE:

The study was led by Oktyabr Teshaev, Tashkent State Medical University, Tashkent, Uzbekistan. It was published online in Obesity Surgery.

LIMITATIONS:

The retrospective study design and absence of a control group are notable limitations. The single-region study population may limit generalizability. Cardiovascular outcomes, quality of life, and mechanistic metabolic pathways were not assessed.

DISCLOSURES:

No funding information was reported. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.