Can sleeve gastrectomy cure type 2 diabetes? For many patients, the answer may be yes, depending on how we define a cure.

Sleeve gastrectomy can dramatically improve type 2 diabetes. Some patients achieve normal blood sugar levels without diabetes medications and maintain those results for many years.

The medical community generally refers to this as diabetes remission rather than a cure because diabetes can recur. However, when a patient maintains normal glucose levels without medication for five years or longer, the distinction between prolonged remission and what might reasonably be considered a functional cure becomes largely semantic.

The important questions are how frequently patients achieve sustained remission, how long those improvements last, and which patients are most likely to benefit from metabolic surgery. In this article, we’ll examine those questions and the evidence behind them.

Does type 2 diabetes help you qualify for bariatric surgery? Under Arkansas Act 628, adults with a BMI of 35 or higher and an obesity-related condition such as type 2 diabetes may qualify for bariatric surgery coverage through eligible insurance plans. Learn more about eligibility, insurance requirements, and how to verify your benefits in our Arkansas Act 628 bariatric surgery insurance guide.

To learn more about medical eligibility, including BMI requirements, read Do I Qualify for Bariatric Surgery in Arkansas?

What is Type 2 Diabetes?

Type 2 diabetes is a chronic metabolic disease in which the body becomes resistant to insulin and, over time, may lose some of its ability to produce enough insulin to maintain normal blood sugar levels.

Insulin is a hormone produced by the pancreas that helps glucose move from the bloodstream into the body’s cells, where it can be used for energy. When cells become resistant to insulin, the pancreas initially compensates by producing more. Eventually, insulin production may become insufficient to overcome this resistance, causing blood sugar levels to rise.

Obesity, particularly excess abdominal and visceral fat, is an important risk factor for type 2 diabetes. Genetics, age, physical activity, and other metabolic factors also contribute.

Over time, poorly controlled diabetes can damage the heart, blood vessels, kidneys, nerves, and eyes. Fortunately, substantial weight loss and metabolic surgery can dramatically improve insulin resistance and blood sugar control, sometimes allowing patients to maintain normal glucose levels without diabetes medications.

What is a Sleeve Gastrectomy?

Sleeve gastrectomy, commonly called gastric sleeve surgery, is a minimally invasive bariatric procedure in which approximately 75–80% of the stomach is removed, leaving a smaller, tube-shaped stomach.

The procedure helps patients lose weight by reducing the amount of food they can comfortably eat. However, its metabolic benefits extend beyond simply making the stomach smaller.

Sleeve gastrectomy also changes gastrointestinal hormones involved in hunger, fullness, insulin secretion, and glucose metabolism. These changes, combined with substantial weight loss and improvements in insulin sensitivity, can lead to significant improvements in type 2 diabetes.

In some patients, blood sugar levels improve within days or weeks of surgery, before substantial weight loss has occurred. This early response demonstrates that metabolic surgery affects diabetes through mechanisms beyond weight reduction alone.

Long-term diabetes outcomes vary depending on factors such as the duration of diabetes, preoperative insulin use, pancreatic beta-cell function, and the amount of weight lost and maintained.

Read more about the benefits of sleeve gastrectomies here.

Can Type 2 Diabetes be Cured with Sleeve Gastrectomy?

The short answer is yes, in my opinion. Let me give you a real-world example.

Scott is a 58-year-old male who weighed 410 pounds when we first met in May of 2021, having already suffered a heart attack several years prior. Looking at his health record, it wasn’t hard to see why. Scott’s diabetes necessitated 100 units of insulin a day through his insulin pump. But even the insulin pump couldn’t keep his diabetes under tight control, because his HbA1c would routinely exceed 9.

In addition to type 2 diabetes, Scott also had hypertension and sleep apnea. His genetics were also working against him, with a father and several grandparents that had suffered from heart disease.

Scott was a ticking time bomb. After his cardiologist and nurse practitioner recommended bariatric surgery, he came to my office requesting assistance.

Scott had a sleeve gastrectomy in January of 2022. Since then, he has lost over 100 pounds. He has gone from a 50” waist to a 42” waist. He is off all of his hypertensive medications. His sleep apnea has vastly improved. The most exciting improvement is the response his blood sugars have had to the procedure: he is off all his diabetes medications, his HbA1c is now 5, and his continuous glucose monitor runs from 80 to 100.

While Scott loves the fact that his insulin pump is in a drawer, it’s the quality-of-life improvements that bring a smile to his face. For instance, he can tie his own shoes. His wife can wrap her arms all the way around him for an extra-big hug. His energy is back, and he’s more involved in his life. Plus, he’s looking forward to go-carting with his grandson.

This is the kind of transformation that makes me love my job!

Scott’s story, while impressive, is not unusual. But is he cured of his diabetes? It depends on who you ask.

I would say that we need to wait and see what happens. Because Scott is off all diabetes medications and has a normal A1c, I would say he is in remission. If he goes back on his medication or his A1c bumps, I would say that his diabetes has recurred. If he stays off his meds with a normal A1c for 5 years, I would say he is cured, but purists would argue that he is in long-term remission. Even if he lives to be 150 years old and never gets back on his medications, some would argue he was never cured but in “permanent remission.”

I don’t want to argue semantics. In my mind, if you stay off all meds and your A1c is normal for 5 years, you’re cured.

What Does Science Say About Sleeve Gastrectomy Curing Type 2 Diabetes?

Over the past three decades, bariatric surgeons have observed something remarkable: patients undergoing weight-loss surgery sometimes experience dramatic improvements in type 2 diabetes, including normalization of their blood sugar levels and complete elimination of diabetes medications.

What began as a clinical observation has since been supported by decades of scientific research. We now know that sleeve gastrectomy can improve blood sugar control, reduce or eliminate the need for diabetes medications, and produce remission that lasts for many years in some patients.

The more challenging question is how often that remission occurs and whether it lasts. Some patients maintain normal blood sugar levels without medication for five years or longer, while others experience a recurrence of diabetes over time.

The following studies help answer those questions, including how frequently sleeve gastrectomy produces diabetes remission, how durable those results are, and which patients are most likely to benefit.

Can Sleeve Gastrectomy “Cure” Diabetes? — Annals of Surgery, 2016

A landmark study from the Cleveland Clinic examined the long-term effects of sleeve gastrectomy on 134 patients with type 2 diabetes, with a median follow-up of six years.

The study found substantial long-term improvements in diabetes control:

• 63% achieved good blood sugar control, defined as an HbA1c below 7%, compared with 31% before surgery.
• 26% achieved diabetes remission, with an HbA1c below 6.5% without diabetes medications.
• 11% achieved complete remission, with an HbA1c below 6.0% without medications.
• 3% maintained complete remission continuously for at least five years—an outcome the researchers themselves described as a “cure.”

Among patients who initially achieved diabetes remission, 44% experienced a recurrence during follow-up. However, 67% of those whose diabetes returned maintained an HbA1c below 7%, indicating continued improvement in blood sugar control.

Overall, sleeve gastrectomy produced meaningful and lasting improvements in diabetes control, but sustained medication-free remission was relatively uncommon. Only 3% met the researchers’ definition of a “cure,” which required complete remission lasting continuously for at least five years.

Research: Aminian et al., Can Sleeve Gastrectomy “Cure” Diabetes?, Annals of Surgery (2016)

Are the Benefits of Sleeve Gastrectomy Sustained After Nine Years? — Obesity Surgery, 2025

A 2025 study published in Obesity Surgery examined long-term outcomes in a group of 361 patients with type 2 diabetes who underwent sleeve gastrectomy, with follow-up extending as far as nine years.

The findings demonstrated meaningful, sustained improvements in diabetes control:

• Average HbA1c decreased from 8.1% before surgery to approximately 6.8% at nine years, indicating substantially improved long-term blood sugar control.
• Approximately 20% of evaluated patients achieved complete diabetes remission at five, seven, and nine years after surgery.
• Diabetes recurrence occurred in some patients, with reported relapse rates ranging from approximately 10% to 23% during later follow-up.

These results demonstrate that sleeve gastrectomy can provide lasting metabolic benefits, even when complete diabetes remission is not achieved or maintained.

Importantly, this study also reinforces why we should distinguish between improvement in diabetes control and complete remission. Both are valuable outcomes, but not every patient will remain medication-free indefinitely.

Research: Elhag et al., Sleeve Gastrectomy in Patients with Type 2 Diabetes: Anthropometric and Cardiometabolic Improvements at 1, 3, 5, 7, and 9 Years: Are the Initial Benefits Sustained?, Obesity Surgery (2025)

Five-Year Diabetes Outcomes After Sleeve Gastrectomy — NEJM, 2017

The STAMPEDE trial, published in the New England Journal of Medicine, followed 150 patients with type 2 diabetes who were randomly assigned to intensive medical treatment, sleeve gastrectomy plus medical treatment, or gastric bypass plus medical treatment.

At five years, 23% of patients who underwent sleeve gastrectomy achieved an HbA1c of 6.0% or lower, compared with only 5% of patients receiving intensive medical treatment alone.

Importantly, this outcome was a measure of blood sugar control and did not require patients to be completely off diabetes medications. It should therefore not be interpreted as a 23% medication-free remission rate.

Patients undergoing metabolic surgery also experienced substantial weight loss and improvements in several measures of metabolic health.

This randomized trial supports sleeve gastrectomy as a treatment capable of producing meaningful improvements in diabetes control over five years, even when complete remission is not achieved.

Research: Schauer et al., Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes, New England Journal of Medicine (2017)

So, Can Sleeve Gastrectomy Cure Type 2 Diabetes?

For some patients, I believe the answer is yes—depending on how we define a cure.

Sleeve gastrectomy can produce remarkable improvements in type 2 diabetes. Some patients achieve normal blood sugar levels without medications and maintain those results for many years. Others experience significant improvements in diabetes control but continue to require medication.

The research shows that long-term remission is possible, although it is not guaranteed. Patients with a shorter history of diabetes, less dependence on medications, and better-preserved insulin production generally have the greatest chance of achieving remission.

The medical community prefers the term remission because diabetes can return. However, when someone maintains normal blood sugar levels without medication for five, ten, or more years, I believe the distinction between prolonged remission and a functional cure becomes largely semantic.

Ultimately, what matters most is the patient’s health. Reducing or eliminating diabetes medications, improving blood sugar control, and potentially lowering the risk of long-term complications are meaningful benefits, whether we call the outcome remission or cure.

Patients with type 2 diabetes may also wonder whether modern weight-loss medications such as Ozempic, Wegovy, or Zepbound offer similar benefits to metabolic surgery. Both approaches can improve blood sugar control, but they differ in long-term weight loss, diabetes remission, and treatment requirements. I explore these differences in my article on bariatric surgery versus Ozempic, Wegovy, and Zepbound.

Considering Sleeve Gastrectomy for Type 2 Diabetes?

If you have obesity and type 2 diabetes, an individualized surgical evaluation can help determine whether sleeve gastrectomy is an appropriate treatment option.

Dr. Samuel Bledsoe is a board-certified general and bariatric surgeon and Medical Director of Bariatric & Metabolic Surgery at UAMS Health in Bryant, Arkansas.

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