Type 2 Diabetes Remission and Skeletal Muscle
TYPE 2 diabetes remission after sleeve gastrectomy may be linked to skeletal muscle status before and after surgery, according to new retrospective data from Japan.
The study examined 90 patients who underwent laparoscopic sleeve gastrectomy for severe obesity at Hokkaido University Hospital, Sapporo, Japan, between October 2016 and February 2024. Investigators assessed perioperative outcomes, weight loss, and obesity related comorbidities, with a particular focus on skeletal muscle mass measured using bioelectrical impedance analysis.
At 6 months after surgery, median total weight loss reached 21%, while median excess weight loss was 52%. Type 2 diabetes remission occurred in approximately 60% of cases, rising to 75% when both remission and improvement were considered. Hypertension and dyslipidemia improved in approximately half of patients.
Higher Skeletal Muscle Seen in Remission Group
Among patients with type 2 diabetes and at least 1 year of follow up, 35 achieved remission and 16 did not. Five patients were excluded from this analysis because their postoperative follow up was shorter than 1 year.
Univariate analyses identified several factors associated with type 2 diabetes remission, including duration of type 2 diabetes treatment, body fat percentage, muscle mass, and skeletal muscle mass. Skeletal muscle mass did not remain a statistically significant independent predictor after adjustment for established clinical factors, meaning the association should not be interpreted as causal or isolated.
However, patients who achieved remission generally had significantly higher muscle and skeletal muscle masses during the preoperative and postoperative periods. Skeletal muscle percentage also remained significantly higher in the remission group at 3, 6, and 12 months after surgery.
Perioperative Muscle Management May Matter
The findings support skeletal muscle as a potentially important contributory factor in metabolic outcomes after laparoscopic sleeve gastrectomy. Skeletal muscle has a central role in glucose metabolism, and the authors suggested that perioperative management focused on preserving or improving skeletal muscle may help support type 2 diabetes remission after surgery.
The study’s retrospective design, small sample size, short follow up, and use of bioelectrical impedance analysis limit interpretation. Postoperative muscle measurements may also be affected by hydration status and fluid shifts. Further studies with longer follow up are needed to clarify whether targeted rehabilitation or resistance exercise before and after surgery can improve glycemic outcomes in patients undergoing laparoscopic sleeve gastrectomy.
Reference
Takano H et al. Relationship between remission rate of type 2 diabetes and skeletal muscle after laparoscopic sleeve gastrectomy. Biomedical Reports. 2026;24(6):79.
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