ABSTRACT 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 (ST 2 OMP) 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/m 2 ) and 40 participants receiving advanced medical therapy (AMT) (mean age 16.9 years, 53% female, HbA1c 7.8%, BMI 42.2 kg/m 2 ). 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, 55 mg/dL, and 45 mg/dL (all p < 0.01). After BMI adjustment, preoperative HbA1c predicted postoperative glucose metrics. Conclusion Adolescents with type 2 diabetes experience early glycemic normalization post‐VSG, even before major weight loss.
SEGEV et al. (Mon,) studied this question.