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| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Artículo Open Access |
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Wiley
2026
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| Online Access: | https://onlinelibrary.wiley.com/doi/10.1002/oby.70140 |
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Table of Contents:
- Impact of Vertical Sleeve Gastrectomy in Youth‐Onset Type 2 Diabetes: Changes in Glycemia, Insulin Sensitivity, and Secretion Tyler J. Dobbs Laura Pyle Jaime M. Moore Justin Garrish Cecilia Diniz Behn Dylan Weissenkampen Amy D. Baumgartner Susan Gross Grant Schutte Carissa Birznieks Isabella Melena Lauryn Remmers Lynette Driscoll Melanie G. Cree Megan M. Kelsey Amy S. Shah Thomas H. Inge Petter Bjornstad Kristen J. Nadeau Obesity ABSTRACT Objective This study evaluated impacts of vertical sleeve gastrectomy (VSG) on glycemic and cardiometabolic outcomes in youth‐onset type 2 diabetes (YO‐T2D). Methods Pre‐ and postoperative (3 and 12 months) anthropometrics, mixed‐meal tolerance test (MMTT) and body composition assessments, and hyperglycemic clamps (preoperative and 12 months postoperatively) were performed. Results Weight (−24.6 ± 5.2 kg at 3 months; −31.0 ± 5.2 kg at 12 months) and BMI (−8.5 ± 2.0 kg/m 2 ; −10.8 kg/m 2 ) fell by 18% and 23%, respectively (all p < 0.01). Body fat decreased 6.4% ( p = 0.01) at 12 months, and fat mass by 16.8 ± 4.7 kg ( p = 0.01). MMTT‐stimulated GLP‐1, PYY, insulin, and C‐peptide secretion increased and insulin clearance, glucose, HbA1c (6.6% ± 0.2% to 5.7% ± 0.2%, p = 0.003), free fatty acids (FFA), LDL, triglycerides, adipose‐focused Adipo‐IR, liver transaminases and hepatic‐predominant insulin sensitivity (Si) (HOMA‐IR) decreased at 3 months post VSG. With maximal 12‐month weight loss, MMTT‐stimulated insulin, C‐peptide, and GLP‐1 responses attenuated, insulin clearance increased, muscle‐predominant Si (hyperglycemic clamp M/I, Matsuda index, static/dynamic oral minimal modeling), β‐cell function, resting heart rate, systolic blood pressure, and HDL improved, and all 3‐month improvements persisted, with 86% of participants off diabetes medications. Conclusions VSG in YO‐T2D produces rapid and sustained improvements in weight, body composition, cardiometabolic health, Si, FFA, β‐cell function, and glycemia, with most no longer needing diabetes medications. Trial Registration: ClinicalTrials.gov identifier: NCT03620773. 10.1002/oby.70140 http://onlinelibrary.wiley.com/termsAndConditions#vor