Public Metabolic Bariatric Surgery in Adults With Obesity and Diabetes: 2‐Year Safety, Weight and Diabetes Outcomes

BACKGROUND: Metabolic bariatric surgery (MBS) is a safe and effective treatment for severe obesity and type 2 diabetes. However, access to MBS in Australia, remains largely confined to the private healthcare sector. We examined 2-year safety and efficacy outcomes of MBS performed in adults affected by obesity and diabetes, within a high-volume, public hospital in Queensland, Australia. METHODS: and diagnosis of type 2 diabetes. Patient demographics, 90-day postoperative complications, and 1- and 2-year weight and diabetes outcomes were collated. RESULTS: ) underwent MBS. Preoperatively, mean HbA1c was 9.0 (1.5) % and 65% of patients required insulin. Procedures included Roux-en-Y gastric bypass (78.8%), sleeve gastrectomy (15.7%) and one-anastomosis gastric bypass (5.3%). All patients were followed up to 1 year, and 219 patients (96.9%) were followed up to 2 years. Median length of stay was 2 days (range: 2-18). Seven patients (3.1%) developed a clinically significant postoperative complication within 90 days. There was no mortality. Mean percentage total body weight loss was 29.6 (8.2) % and 31 (11.4) % at 1 and 2 years. 120 patients (54.8%) achieved complete diabetes remission at 2 years. CONCLUSION: Public MBS is safe and effective, producing significant and sustained weight loss and improvements in diabetes at 2 years.