Which bariatric surgery is associated with significant remission of diabetes?

The surgical procedure most closely associated with significant remission of diabetes is Roux-en-Y gastric bypass. This approach significantly alters both the anatomy and physiology of the gastrointestinal tract, leading to a decrease in caloric intake and changes in gut hormone secretion that lower blood glucose levels and improve insulin sensitivity.

Individuals who undergo Roux-en-Y gastric bypass often experience rapid weight loss and, for many, a significant resolution or improvement of type 2 diabetes shortly after surgery. This effect is thought to be due in part to the bypass of the duodenum, which plays a critical role in glucose metabolism. Furthermore, hormonal changes, such as increased levels of glucagon-like peptide-1 (GLP-1), also contribute to better glycemic control.

While other procedures, such as SADI-S (Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy) and Vertical Sleeve Gastrectomy, also show promise in managing diabetes, the accumulation of evidence points to Roux-en-Y gastric bypass as having the most robust and established association with diabetes remission in the current literature. Meanwhile, Adjustable gastric banding has not shown significant effects on diabetes remission, as it primarily results in weight loss without the same degree of metabolic changes associated with diabetes