Among 129 adults aged 60 or older (median age 66, 62% female) with type 2 diabetes who underwent laparoscopic sleeve gastrectomy between 2008 and 2022, 80 (62.0%) reached diabetes remission at a median follow-up of 6.0 years, while 16 (12.4%) saw no clinical change. Median total weight loss was 19.4% and excess weight loss 47.8%. Diabetes lasting more than 10 years predicted a lower chance of remission (p = 0.007).
A 62% remission rate at six years is notable in an age group often steered away from surgery over perioperative risk concerns, and it fits the broader pattern from randomized trials such as STAMPEDE and the Swedish Obese Subjects cohort, where metabolic surgery outperforms medical therapy for glycemic control. The duration finding also matches earlier work: longer disease means more beta-cell loss, so surgical weight loss restores less insulin secretion. The practical message is that timing matters, and a decade of diabetes narrows the window. Limitations are substantial. The design is retrospective, there is no medical-therapy comparison group, and the paper reports no complication or mortality rates, which are central to judging surgery in older adults. Remission definitions in chart-based studies vary, and attrition over 6 years can inflate success. Survivor and selection bias are also likely, since only fit older patients reach the operating room. This is confirmatory rather than paradigm-shifting, but it supports earlier referral discussions for eligible older adults with obesity and diabetes.