Hormonal
Metabolic bariatric surgery leads to sustained HbA1c reduction, whereas non-surgical management is associated with HbA1c increase in patients with type 2 diabetes.
For patients with severe obesity and type 2 diabetes, metabolic bariatric surgery offers significantly better long-term weight loss and blood sugar control than non-surgical management. While surgery is not for everyone, those who undergo it maintain much greater weight loss (22% vs 8.6%) and better glycemic control over five years. If surgery is not an option, intensive lifestyle modification and pharmacotherapy are critical alternatives to mitigate health risks.
HbA1c decreased by 1.0% (95% CI: −1.31, −0.70) in the surgery group but increased by 0.4% (95% CI: 0.09, 0.71) in the non-surgery group.
Why this rating
Retrospective cohort study with real-world data, large sample size, and 5-year follow-up.
Source
Metabolic bariatric surgery pays off: a longitudinal analysis of weight loss and HbA1c changes in real-world patients data in the West of Scotland
Beatrice J. Leyaro et al. · International Journal of Obesity · 2025
DOI 10.1038/s41366-025-01956-6
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