1163-P: Type 2 Diabetes Remission Persists Ten Years after Adolescent Metabolic and Bariatric Surgery

Introduction: Metabolic and bariatric surgery (MBS) is a safe and efficacious weight loss treatment for children and adolescents with severe forms of obesity. However, there are limited long-term data on treatment effectiveness of MBS for youth-onset type 2 diabetes (YO-T2D). We examined 10-year weight and T2D outcomes among adolescents undergoing MBS.

Methods: We analyzed longitudinal data from 21 individuals who prior to MBS (67% Roux-en-Y gastric bypass, 33% vertical sleeve gastrectomy [VSG]) were < 19 years of age, had ≥ Class 2 obesity and YO-T2D, and were prospectively enrolled in the multi-center, Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study.

Definitions: T2D remission= no prescribed glucose lowering medication and normoglycemia (HbA1c <5.7%); partial remission= no medications and HbA1c 5.7%-<6.5%; no remission= current glucose lowering prescription and/or HbA1c ≥ 6.5%. A fasting blood glucose of <100 mg/dL was substituted for one missing follow-up HbA1c. Data presented as mean±SD or percentage.

Results: At the time of MBS, the cohort was 76% female, 57% non-Hispanic white, and had a mean age of 16.7±1.2 years, BMI 53.9±9.2 kg/m², and HbA1c 6.8±2.0%. At 10-years post-MBS, 71% of individuals (15/21) experienced remission of T2D and had a 29±18% BMI reduction. Remission rates were similar between surgical types. Twenty-nine percent (6/21) did not experience T2D remission by 10 years post-MBS, and only experienced 4±14% BMI decrease. Of the six individuals without remission at 10 years post-MBS, 3/6 previously had remission (in the interim data collection periods) and one had partial remission 1-year post-MBS, with a return of T2D-range HbA1c in subsequent years.

Conclusion: T2D resolution occurred in a high proportion of adolescents post-MBS, and was durable to 10-years of follow-up. Further study is needed to better understand outcomes in diverse populations of YO-T2D, underlying mechanisms of remission and reasons for low weight loss/lack of remission.