To explore the effects of bariatric metabolic surgery (BMS) on gastrointestinal peptides and blood glucose control in obese patients with type 2 diabetes.

A prospective selection was made of 124 patients with type 2 diabetes mellitus complicated with obesity who underwent BMS in the First, the Second and the Fourth Affiliated Hospital of Xinjiang Medical University from March 2022 to July 2024 as the research subjects. Among them, 64 cases underwent sleeve gastrectomy (SG group), and 60 cases underwent Roux-en-Y gastric bypass surgery (RYGB group). The surgical-related indicators, blood glucose control before and one year after the operation, gastrointestinal peptide levels, body fat components and nutritional indicators, psychological state and quality of life, as well as the occurrence of complications were compared between the two groups.

There were no statistically significant differences in baseline data such as age and gender between the two groups (P>0.05). The operation time and cost in the RYGB group were higher than those in the SG group (P<0.001), while there were no statistically significant differences in intraoperative blood loss, the time of first postoperative exhaust and postoperative hospital stay (P>0.05). One year after the operation, the blood glucose control, gastrointestinal peptide levels, body fat composition and nutritional indicators, psychological state and quality of life in both groups were significantly improved, and the improvement in the RYGB group was greater (P<0.05). Moreover, after adjusting for baseline body mass index, age and duration of diabetes, the amplitude of changes in gastrointestinal peptides was significantly correlated with the improvement of blood glucose (P<0.05). In addition, there was no statistically significant difference in the total incidence of complications between the two groups (P>0.05). The insulin discontinuation rate and hypoglycemic drug remission rate in the RYGB group were significantly higher than those in the SG group (P<0.05). The weight rebound rates of both groups one year after the operation were at a relatively low level, and there was no statistically significant difference (P>0.05).

BMS can effectively improve blood glucose control, gastrointestinal peptide levels and body fat metabolism in obese patients with type 2 diabetes. Among them, RYGB surgery shows advantages in promoting the remission of hypoglycemic drugs and improving the quality of life, without increasing the overall risk of complications and weight rebound.