PREDICTIVE FACTORS FOR SUCESSFUL REMISSION OF TYPE 2 DIABETES AFTER BARIATRIC SUGERY

Abstract

Bariatric surgery has been consolidated as an effective intervention for the control and remission of type 2 diabetes mellitus (T2DM), especially in individuals with associated obesity. This study aimed to review and analyze the relationship between T2DM remission and bariatric surgery, exploring the mechanisms involved in improving glycemic control after the procedure, comparing the different available surgical techniques, evaluating their efficacy in disease remission, and identifying the factors that influence metabolic outcomes, thus providing a comprehensive overview for optimizing treatment and refining surgical indication criteria. A literature review was conducted using the PubMed and BVS medical databases, applying the descriptors “BARIATRIC SURGERY,” “DIABETES TYPE 2,” and “REMISSION,” combined with the Boolean operator “AND.” A total of 25 scientific articles were included after applying inclusion and exclusion criteria. The analyzed studies indicated that clinical factors such as shorter duration of T2DM diagnosis, absence of preoperative insulin use, greater postoperative weight loss, lower glycated hemoglobin (HbA1c) levels, and preserved pancreatic reserve are associated with higher remission rates of T2DM. Surgical techniques involving greater intestinal bypass, such as Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB), demonstrated superiority over sleeve gastrectomy (SG) regarding remission rates. Hormonal changes and modifications of the intestinal microbiota also emerged as relevant factors in postoperative metabolic control. The findings highlight the importance of a careful evaluation of surgical candidates to optimize therapeutic outcomes and reduce long-term complications.