Abstract
BACKGROUND: Obesity and type 2 diabetes mellitus are highly prevalent conditions with a significant public health impact, highlighting the need for effective management strategies. Bariatric surgery is widely recognized for promoting sustained weight loss and high rates of type 2 diabetes mellitus remission. AIMS: This study investigated the preoperative blood glucose response to a very low-calorie diet as a functional predictor of type 2 diabetes mellitus remission following Roux-en-Y gastric bypass. METHODS: 198 participants who followed a very low-calorie diet (600 kcal/day) during the preoperative period were included, with glycemic response monitoring. RESULTS: Complete remission of type 2 diabetes mellitus occurred in 66.7% of patients. Two years after surgery, patients with blood glucose levels below 143 mg/dL on the second day of the very low-calorie diet had a higher likelihood (over 70%) of achieving complete remission type 2 diabetes mellitus in the late postoperative period. CONCLUSIONS: Preoperative capillary blood glucose levels demonstrated good specificity in predicting remissions. These findings reinforce the clinical utility of early glycemic control as a valuable indicator for predicting the success of surgical treatment for type 2 diabetes mellitus.