Type2 Diabetes Mellitus Remission After Sleeve Gastrectomy in Patients 60 Years and Older—A Multicenter Study

Introduction: Driven by impaired insulin secretion and insulin resistance, type 2 diabetes mellitus (T2DM) stands as a chronic metabolic disorder. While metabolic bariatric surgery (MBS) is highly effective, data on older populations remain limited. The objective of this study is to assess the long-term outcomes and clinical predictors of T2DM remission in patients aged 60 and older following sleeve gastrectomy. Materials and Methods: This retrospective cohort study evaluates data retrieved from the medical records of 129 patients aged ≥60 years with T2DM who underwent primary laparoscopic sleeve gastrectomy between 2008 and 2022. Baseline demographic characteristics, body mass index (BMI), T2DM duration, and treatment modalities were extracted. Metabolic outcomes, including total weight loss (%TWL) and excess weight loss (%EWL), were evaluated over a median follow-up of 6.0 years. Results: The cohort had a median age of 66 years, with females accounting for 62% of the population. At the final follow-up, the median %TWL was 19.4%, and the median %EWL was 47.8%. Overall, T2DM remission was achieved in 80 (62.0%) patients, whereas 16 (12.4%) patients experienced no clinical changes. Duration of T2DM of more than 10 years was associated with a lower likelihood of remission of T2DM (p = 0.007). Conclusions: Our findings demonstrate that a substantial proportion of patients aged 60 years and older achieved T2DM remission at the last available follow-up following sleeve gastrectomy. A decreased likelihood of remission correlated with longer preoperative T2DM duration, which highlights the clinical value of offering metabolic surgery early to eligible older patients.