Article1 min read·Published Jun 2026

Glycemic Normalization Immediately Following Vertical Sleeve Gastrectomy in Adolescents With Type 2 Diabetes From the ST2OMP Study

Part of Adolescent Bariatric Surgery 39 items

pubmed.ncbi.nlm.nih.gov

Michael Helmrath

Aim: Youth-onset type 2 diabetes and obesity are rising public health burdens. While newer type 2 diabetes medications lower HbA1c, their impact on paediatric weight loss is inconsistent. In contrast, bariatric surgery improves glycemia and weight in youth and adults, though glycemia post-vertical sleeve gastrectomy (VSG), now the predominant bariatric surgery in youth, remains unstudied in youth-onset type 2 diabetes. We aimed to assess immediate post-VSG glycemic patterns using continuous glucose monitoring (CGM) in adolescents with type 2 diabetes. Materials And Methods: In the Surgical or Medical Treatment for Paediatric Type 2 Diabetes (ST2OMP) study, 73 adolescents with type 2 diabetes underwent 14 days of CGM monitoring: 33 participants beginning in the 1-2 days post-VSG (mean age 17.6 years, 67% female, HbA1c 7.2%, BMI 50.0 kg/m2) and 40 participants receiving advanced medical therapy (AMT) (mean age 16.9 years, 53% female, HbA1c 7.8%, BMI 42.2 kg/m2). CGM analyses included glucose management indicator (GMI), time in range, coefficient of variability, standard deviation, mean amplitude glycemic excursion, percent > 140, 180, and 200, percent < 70 and 60 mg/dL, 7 a.m., and midnight-6 a.m. Results: Mean glucose was 84.3 ± 23.4 in the post-VSG group versus 149.8 ± 78.8 mg/dL in the AMT group (p < 0.001). Mean CGM GMI was normal (5.3%, 34 mmol/mol) post-VSG versus in the diabetes range (6.9%, 52 nmol/mol) with AMT (p < 0.001). VSG participants spent more time < 70 mg/dL,

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Article · Jun 2026 · 1 min read

In brief

This ST2OMP study demonstrates that adolescents with type 2 diabetes achieve rapid glycemic normalization within 1-2 days post-vertical sleeve gastrectomy, with mean glucose dropping to 84 mg/dL versus 150 mg/dL in medically-managed peers. Continuous glucose monitoring revealed normalized glucose management indicators post-surgery, though with increased hypoglycemia risk requiring clinical monitoring.

Written by the GCMD Library team from the article.

Michael Helmrath

Statements in this article

Youth-onset type 2 diabetes and obesity are rising public health burdens.
EstablishedAim
Newer type 2 diabetes medications lower HbA1c but their impact on paediatric weight loss is inconsistent.
EstablishedAim
Bariatric surgery improves glycemia and weight in youth and adults.
EstablishedAim
Vertical sleeve gastrectomy is now the predominant bariatric surgery in youth.
EstablishedAim
In the ST2OMP study, 33 adolescents with type 2 diabetes underwent 14 days of continuous glucose monitoring beginning 1-2 days post-vertical sleeve gastrectomy with mean age 17.6 years, 67% female, HbA1c 7.2%, and BMI 50.0 kg/m2.
ResearchMaterials And Methods
In the ST2OMP study, 40 adolescents with type 2 diabetes receiving advanced medical therapy underwent 14 days of continuous glucose monitoring with mean age 16.9 years, 53% female, HbA1c 7.8%, and BMI 42.2 kg/m2.
ResearchMaterials And Methods
Mean glucose was 84.3 ± 23.4 mg/dL in the post-vertical sleeve gastrectomy group versus 149.8 ± 78.8 mg/dL in the advanced medical therapy group.
ResearchResults
Mean continuous glucose monitoring glucose management indicator was normal at 5.3% (34 mmol/mol) post-vertical sleeve gastrectomy versus in the diabetes range at 6.9% (52 mmol/mol) with advanced medical therapy.
ResearchResults
Vertical sleeve gastrectomy participants spent more time below 70 mg/dL compared to advanced medical therapy participants.
ResearchResults