Metabolic Surgery Led to 58% Diabetes Remission in ARMMS-T2D Long-Term Trial

In a multicenter study tracking 262 patients with type 2 diabetes across up to 14 years, researchers evaluated the durability of metabolic-bariatric surgery compared to intensive medical and lifestyle therapy. The results, published in Diabetes Care, indicate that 58% of patients randomized to surgical interventions reached diabetes remission, defined as an HbA1c below 6.5% without glucose-lowering drugs, compared to 3% in the medical-lifestyle cohort doi.orgDiabetes Caredoi.orgOpen source ↗.

Participants had a mean age of 49.9 years, baseline BMI of 36.4 kg/m², and baseline HbA1c of 8.5%, with 68% being women. Over a median follow-up period of 11 years, the Alliance of Randomized Trials of Medicine vs. Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D) consortium monitored 166 surgical patients and 96 medical-lifestyle patients to evaluate factors governing remission and recurrence doi.orgDiabetes Caredoi.orgOpen source ↗.

Predictors of Treatment Remission

Univariate time-to-event analyses showed that remission correlated with shorter baseline diabetes duration, absence of insulin use, fewer classes of glucose-lowering drugs, greater baseline body weight, higher fasting C-peptide and insulin concentrations, and greater weight reduction at one year doi.orgDiabetes Caredoi.orgOpen source ↗. Multivariate regression established baseline diabetes duration, prior insulin therapy, and magnitude of weight change at one year as independent predictive factors doi.orgDiabetes Caredoi.orgOpen source ↗.

Factors Governing Disease Relapse

Among surgical patients who initially achieved remission, recurrence of the condition occurred over extended follow-up. Analysts determined that longer baseline disease duration and a higher quantity of pre-treatment glucose-lowering medication classes were the primary predictors of diabetes relapse following surgery doi.orgDiabetes Caredoi.orgOpen source ↗.