Published online Jun 27, 2026. doi: 10.4240/wjgs.118659
Revised: February 6, 2026
Accepted: April 10, 2026
Published online: June 27, 2026
Processing time: 142 Days and 17.6 Hours
Obesity and type 2 diabetes mellitus (T2DM) represent a major global health challenge. Although sleeve gastrectomy (SG) effectively induces weight loss and improves glycemic control, long-term outcomes can be limited by weight regain and metabolic fluctuations. Semaglutide, a glucagon-like peptide-1 receptor agonist, complements surgical effects through glucose-lowering and weight-loss mechanisms. We hypothesize that combining SG with semaglutide postoperatively will yield superior and more sustained improvements in glycemic control, weight reduction, and metabolic parameters compared to surgery alone, ad
To assess how SG and semaglutide affects metabolic markers and blood glucose control rate in individuals with T2DM and obesity.
This retrospective cohort study analyzed 80 obese patients with T2DM admitted between December 2022 and June 2025. Patients included observation group (n = 40, SG plus semaglutide) and control group (n = 40, SG alone). We compared postoperative glycemic control rates and changes in fasting plasma glucose, 2-hour postprandial glucose, glycated hemoglobin, serum total cholesterol, triglycerides, low-density lipoprotein cholesterol, body mass index, homeostasis model assessment of β-cell function, and homeostasis model assessment of insulin resistance.
The observation group had a greater percentage of blood glucose control following therapy than the control group. When compared to pre-treatment levels, both groups’ fasting plasma glucose, 2-hour postprandial glucose, glycated hemoglobin, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and body mass index significantly decreased, with the observation group experiencing a larger reduction (P < 0.05). Simultaneously, the observation group demonstrated superior improvement in homeostasis model assessment of β-cell function and a greater reduction in homeostasis model assessment of insulin resistance compared to the control group (P < 0.05). The incidence of adverse outcomes after surgery did not differ significantly according to statistical analysis between the two groups (P > 0.05).
SG paired with semaglutide significantly improves the rate of blood glucose control in obese patients with T2DM, demonstrating superior metabolic benefits and islet function enhancement compared to surgery alone.
Core Tip: This retrospective cohort study in Chinese patients with obesity and type 2 diabetes mellitus found that adding semaglutide after sleeve gastrectomy, compared to surgery alone, significantly improved short-term diabetes remission and metabolic indicators (glucose, lipids, weight, islet function) without extra safety risks. The results demonstrate synergy between surgery and glucagon-like peptide-1 receptor agonist therapy, supporting an integrated “surgery plus postoperative drug intensification” model to address suboptimal or declining long-term outcomes. This offers an evidence-based treatment intensification option for optimizing management in clinical practice.