ARMMS-T2D followed 262 adults with type 2 diabetes for a median 11 years after randomisation in earlier trials. 166 were assigned metabolic-bariatric procedures and 96 intensive medical-lifestyle management; mean baseline HbA1c was 8.5%, BMI 36.4 kg/m2. Remission, HbA1c below 6.5% off glucose-lowering drugs, occurred in 58% of the procedure arm and 3% of the medical arm. Baseline diabetes duration, insulin use and weight change at 1 year predicted remission in multivariate analysis. Within the procedure arm, longer diabetes duration and more glucose-lowering drug classes predicted relapse after remission. The pooled sample of 262, drawn from separate earlier trials, is modest.
Why it is interesting: Gives long-term remission and relapse rates for metabolic-bariatric procedures against medical management. It also sets out the baseline features separating those who remit from those who do not.
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