Li JP, Wang L, Dong L, Bai C. Impact of semaglutide with sleeve gastrectomy on blood glucose control and metabolism in obese type 2 diabetics. World J Gastrointest Surg 2026; 18(6): 118659 [DOI: 10.4240/wjgs.118659]
Corresponding Author of This Article
Chun Bai, Chief Physician, Department of Breast Oncology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, No. 141 Tianjin Road, Huangshigang District, Huangshi 435002, Hubei Province, China. baichun591269224@163.com
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Endocrinology & Metabolism
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Li JP, Wang L, Dong L, Bai C. Impact of semaglutide with sleeve gastrectomy on blood glucose control and metabolism in obese type 2 diabetics. World J Gastrointest Surg 2026; 18(6): 118659 [DOI: 10.4240/wjgs.118659]
World J Gastrointest Surg. Jun 27, 2026; 18(6): 118659 Published online Jun 27, 2026. doi: 10.4240/wjgs.118659
Impact of semaglutide with sleeve gastrectomy on blood glucose control and metabolism in obese type 2 diabetics
Jin-Ping Li, Lei Wang, Li Dong, Chun Bai
Jin-Ping Li, Nursing Department of Medical College, Yangzhou Polytechnic University, Yangzhou 225009, Jiangsu Province, China
Lei Wang, Department of Endocrinology, Nanjing Lishui District People’s Hospital, Nanjing 211200, Jiangsu Province, China
Li Dong, Department of Endocrinology, Nanjing Red Cross Hospital, Nanjing 210001, Jiangsu Province, China
Chun Bai, Department of Breast Oncology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi 435002, Hubei Province, China
Co-first authors: Jin-Ping Li and Lei Wang.
Author contributions: Li JP and Wang L participated in the research design and data collection, conducted data analysis and paper writing as co-first authors; Dong L was responsible for research and design, funding application, and data analysis; Bai C is responsible for reviewing and editing, communication and coordination, ethical review, copyright and licensing, and follow-up; all authors have read and approved the final manuscript.
AI contribution statement: We didn't use AI to write this manuscript. We used DeepL to assist in polishing the language of the manuscript. All text is human-written.
Institutional review board statement: The research was reviewed and approved by Nanjing Red Cross Hospital.
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: No other data available.
Corresponding author: Chun Bai, Chief Physician, Department of Breast Oncology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, No. 141 Tianjin Road, Huangshigang District, Huangshi 435002, Hubei Province, China. baichun591269224@163.com
Received: January 23, 2026 Revised: February 6, 2026 Accepted: April 10, 2026 Published online: June 27, 2026 Processing time: 152 Days and 0.8 Hours
Abstract
BACKGROUND
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, addressing a critical gap in the long-term management of obese T2DM patients.
AIM
To assess how SG and semaglutide affects metabolic markers and blood glucose control rate in individuals with T2DM and obesity.
METHODS
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.
RESULTS
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).
CONCLUSION
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.
