A long-term clinical trial found that metabolic-bariatric surgery led to far higher rates of lasting type 2 diabetes remission than intensive medical and lifestyle management alone.
- Published in Diabetes Care, journal of the American Diabetes Association
- Trial: Alliance of Randomized Trials of Medicine vs. Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D) — described as the largest, longest-running trial of metabolic surgery for diabetes
- Participants: 262 people with type 2 diabetes — 166 assigned to surgery, 96 to medical/lifestyle management. Median follow-up 11 years, up to 14 years
- Remission rate: 58% for surgery group vs. 3% for medical/lifestyle group. Remission defined as A1C below 6.5% without blood sugar-lowering medication
- Factors linked to remission: Shorter duration of diabetes before treatment, no insulin use, fewer types of blood sugar-lowering medications, and greater weight loss in the first year after treatment
- Factors linked to relapse after remission: Longer history of diabetes and taking more types of diabetes medications before treatment
The question has been whether benefits endure — this study shows they do, and suggests surgery could be offered earlier to the right patients, rather than as a last resort, based on characteristics that predict lasting remission.