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

Year: 2026

Type: article

Abstract: ABSTRACT 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 A retrospective review of a prospectively collated database encompassing all patients who underwent MBS at the Royal Brisbane and Women's Hospital's Statewide Bariatric Service between 5 December 2017 and 31 December 2021 was performed. Eligibility for MBS required a BMI ≥ 35 kg/m 2 and diagnosis of type 2 diabetes. Patient demographics, 90‐day postoperative complications, and 1‐ and 2‐year weight and diabetes outcomes were collated. Results A total of 226 patients (61.5% female; mean age 52.5 (SD: 9.2) years; mean BMI 46.0 (6.9) kg/m 2 ) 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.

Source: ANZ Journal of Surgery

DOI: 10.1111/ans.70675