Glycaemic and weight effects of metabolic surgery or semaglutide in diabetes dosage for patients with type 2 diabetes

Sep 19, 2024Diabetes, obesity & metabolism

Blood sugar and weight changes after metabolic surgery or semaglutide treatment in type 2 diabetes

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Abstract

606 patients who underwent metabolic and bariatric surgery (MBS) achieved a mean total weight loss of 26.4% after 2 years.

Semaglutide treatment resulted in a mean total weight loss of 5.2% after 2 years.
Mean glycated haemoglobin levels were significantly lower in the MBS group (42.3) compared to the semaglutide group (50.7) after 2 years.
Complete remission of diabetes was achieved in 63.0% of patients after MBS versus 13.9% after semaglutide.
Both interventions improved weight and glycemic control, but MBS was associated with greater benefits in these outcomes.

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AIM: To compare weight and glucometabolic outcomes of semaglutide and metabolic and bariatric surgery (MBS) for patients with type 2 diabetes and obesity.

MATERIALS AND METHODS: Patients treated with either semaglutide for a duration of ≥2 years or MBS in Sweden were identified within the Scandinavian Obesity Surgery Registry and the National Diabetes Registry and matched in a 1:1-2 ratio using a propensity score matching with a generalized linear model, including age, sex, glycated haemoglobin before treatment, duration of type 2 diabetes, use of insulin, presence of comorbidities and history of cancer, with good matching results but with a remaining imbalance for glomerular filtration rate and body mass index, which were then adjusted for in the following analyses. Main outcomes were weight loss and glycaemic control.

RESULTS: The study included 606 patients in the surgical group matched to 997 controls who started their treatment from 2018 until 2020. Both groups improved in weight and glucometabolic control. At 2 years after the intervention, mean glycated haemoglobin was 42.3 ± 11.18 after MBS compared with 50.7 ± 12.48 after semaglutide treatment (p < 0.001) with 382 patients (63.0%) and 139 (13.9%), respectively, reaching complete remission without other treatment than the intervention (p < 0.001). Mean total weight loss reached 26.4% ± 8.83% after MBS compared with 5.2% ± 7.87% after semaglutide (p < 0.001).

CONCLUSION: Semaglutide and MBS were both associated with improvements in weight and improved glycaemic control at 2 years after the start of the intervention, but MBS was associated with better weight loss and glucometabolic control.

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Glycaemic and weight effects of metabolic surgery or semaglutide in diabetes dosage for patients with type 2 diabetes

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