Revista ABCd (São Paulo). 27 jan, 2026

Preoperative glycemic response to a very low-calorie diet predicts long-term type 2 diabetes remission after bariatric surgery

Mariana Fior Frias Thomaz BORTOLAN
Roberto DE CLEVA
Leandro FERREIRA
Denis PAJECKI
Marco Aurelio SANTO
DOI: https://doi.org/10.1590/0102-67202025000050e1919

Background:

Obesity and type 2 diabetes mellitus are highly prevalent conditions with a significant public health impact, highlighting the need for effective management strategies. Bariatric surgery is widely recognized for promoting sustained weight loss and high rates of type 2 diabetes mellitus remission.

Aims:

This study investigated the preoperative blood glucose response to a very low-calorie diet as a functional predictor of type 2 diabetes mellitus remission following Roux-en-Y gastric bypass.

Methods:

198 participants who followed a very low-calorie diet (600 kcal/day) during the preoperative period were included, with glycemic response monitoring.

Results:

Complete remission of type 2 diabetes mellitus occurred in 66.7% of patients. Two years after surgery, patients with blood glucose levels below 143 mg/dL on the second day of the very low-calorie diet had a higher likelihood (over 70%) of achieving complete remission type 2 diabetes mellitus in the late postoperative period.

Conclusions:

Preoperative capillary blood glucose levels demonstrated good specificity in predicting remissions. These findings reinforce the clinical utility of early glycemic control as a valuable indicator for predicting the success of surgical treatment for type 2 diabetes mellitus.


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ABCD – BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY is a periodic with a single annual volume in continuous publication, official organ of the Brazilian College of Digestive Surgery - CBCD. Technical manager: Dr. Francisco Tustumi | CRM: 157311 | RQE: 77151 - Cirurgia do Aparelho Digestivo

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