Glycemic outcomes in patients with type 2 diabetes after bariatric surgery compared with routine care: a population-based, real-world cohort study in the United Kingdom

Pushpa Singh, Nicola J. Adderley, Anuradhaa Subramanian, Krishna Gokhale, Jonathan Hazlehurst, Rishi Singhal, Srikanth Bellary, Abd A. Tahrani, Krishnarajah Nirantharakumar*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Clinical trials have shown that bariatric surgery (BS) is associated with better glycemic control and diabetes remission in patients with type 2 diabetes (T2D) compared with routine care. Objective: We conducted a real-world population-based study examining the impact of BS on glycemic control and medications in patients with T2D. Setting and Methods: This was a retrospective, matched, controlled cohort study conducted between January 1, 1990, and January 31, 2018, using IQVIA Medical Research Data, a primary care electronic records database. Adults with body mass index (BMI) ≥30 kg/m 2 and T2D who had BS (surgical) were matched for age, sex, BMI, and diabetes duration to two controls (with T2D and no BS). Results: A total of 1126 patients in the surgical group and 2219 patients in the control group were analyzed. Mean (standard deviation) age was 50.0 (9.3) years, 67.6% were women, baseline glycocylated hemoglobin (HbA1C) was 7.8% (1.7 mmol/mol), and diabetes duration was 4.7 years (range, 2.0–8.4 years). Over a median (interquartile range) follow-up of 3.6 years (1.7–5.9 years), a higher proportion of patients in the surgical group achieved an HbA1C of ≤6.0% than the control group (65.8% versus 22.8%). The surgical group showed a decrease in mean HbA1C of 1.5% (95% confidence interval [CI]: 1.4%–1.7%), 1.4% (1.2%–1.5%), and 1.3% (1.1%–1.5%) at 1-, 2-, and 3-year follow-up, respectively, whereas HbA1C increased in the control group. The proportion of patients receiving glucose-lowering medications decreased in the surgical group (92.2% to 66.5%) but increased in the control group (85.3% to 90.2%). Conclusion: BS is associated with significant improvement in glycemic control, achievement of normal HbA1C levels, and reduced need for glucose-lowering therapy in patients with T2D.

Original languageEnglish
Pages (from-to)1366-1376
Number of pages11
JournalSurgery for Obesity and Related Diseases
Issue number12
Early online date8 Aug 2022
Publication statusPublished - Dec 2022

Bibliographical note

© 2022, Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery. This accepted manuscript version is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License


  • Adult
  • Humans
  • Female
  • Middle Aged
  • Male
  • Diabetes Mellitus, Type 2/complications
  • Glycated Hemoglobin A/analysis
  • Cohort Studies
  • Retrospective Studies
  • Treatment Outcome
  • Bariatric Surgery
  • Blood Glucose
  • United Kingdom/epidemiology


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