One-Anastomosis Gastric Bypass associated with high Long-Term Diabetes Remission: Study

In order to evaluate the effectiveness and durability of the surgery in relation to its metabolic and weight loss outcomes, a retrospective study was carried out on a series of 127 consecutive patients, having undergone laparoscopic OAGB surgery during January to December 2015. The subjects had a mean age of 48.2 years, mean BMI of 38.2 kg/m², and a mean duration of diabetes of 9.45 years. Importantly, 47 patients (37%) were completely dependent on insulin prior to surgery and formed a group of severely ill subjects. Definition of total remission was based on criteria developed by American Diabetes Association (ADA), which implies achieving HbA1c under 6.5% and fasting blood glucose under 100 mg/dL without using any antidiabetics for 12 months. Interestingly, the study managed to attain full patient follow up throughout all the ten-year observation period, resulting in an outstandingly complete set of data.

Key findings:

• 120 out of 127 patients (94.5%) experienced and maintained a complete diabetes remission at the 10-year mark after the operation.
• 100% of the 47 patients who received insulin shots each day prior to the surgery stopped using insulin after the operation.
• The other 7 patients (5.5%) who did not reach the criteria of complete remission still showed great improvement in their metabolism and cut down the number of medicines used every day greatly.
• The group reached an extremely high average excess weight loss (%EWL) of 96.3% (±18.7%) and total weight loss (%TWL) of 33.3% (±6.2%).
• The plasma HbA1c levels decreased rapidly right after the operation and stayed within the normal (non-diabetic) target range until the end of the decade of monitoring.
• 100% of all 68 patients younger than 50 years old had complete remission of T2DM. Moreover, the patients whose duration of diabetes was shorter (3-5 years) managed to get into remission much faster than those whose diabetes was longer.
• The level of C-peptide lower than 2.0 ng/mL was found as the strongest predictor of not achieving remission by 6 of 7 patients who failed to do so (p<0.001).

The laparoscopic OAGB is considered a highly effective and safe procedure for obesity and type 2 diabetes surgery. This technique offers sustained weight loss and excellent glucose regulation after 10 years. The surgical mechanism involves both gastric restriction and partial malabsorption that safely modulates gut peptides in order to address insulin resistance. There have been no deaths, no significant complications during surgery, and 94.5% remission after 10 years.

Reference:

Teshaev, O., Murodov, A., Jumaev, N. et al. Laparoscopic One Anastomosis Gastric Bypass (OAGB) for Type 2 Diabetes Mellitus: A 10-Year Single-Center Experience with 127 Patients. OBES SURG (2026). https://doi.org/10.1007/s11695-026-08646-w