ARMMS-T2D identifies predictors of diabetes remission after bariatric surgery

The ARMMS-T2D analysis assessed baseline predictors of type 2 diabetes remission and subsequent relapse among 262 adults previously randomized to metabolic-bariatric surgery (166) or medical-lifestyle management (96). Participants had a mean age of 49.9 years, mean BMI of 36.4 kg/m² and mean HbA1c of 8.5%. Remission was defined as HbA1c below 6.5% without glucose-lowering medication. Follow-up had a median duration of 11 years, with a maximum of 14 years.

Overall, 58% of participants assigned to surgery achieved remission, compared with 3% assigned to medical-lifestyle management. In multivariable analyses, shorter diabetes duration, no baseline insulin use and weight change at one year predicted remission. Among participants who initially achieved remission after surgery, longer diabetes duration and use of more glucose-lowering medication classes at baseline predicted relapse.

These findings may help characterize which patients are more likely to achieve or sustain remission, but the abstract does not report a validated prediction tool or show that using these predictors to select treatment improves outcomes. The analysis draws on a relatively small cohort and combines three surgical procedures; full-text methods and results were unavailable in the supplied material.