Skip to main contentLast updated: 06-Nov-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Stomach & Gastro Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
For many people with type 2 diabetes, metabolic surgery brings sugar back to normal, without diabetes medicines. This is called remission. It is a real result, but it is not promised to everyone.
Your chance depends on how long you have had diabetes, whether you take insulin, how much insulin your body still makes, and how much weight you lose.
Remission is not a one-time fix. Sugar can creep back, so blood tests, vitamins and yearly check-ups continue for life.
The whole story of the operations, the tests and the follow-up is on our bariatric and metabolic surgery page. This post covers one question: what to expect for your diabetes.
Remission means your sugar stays below the diabetes range even though you take no diabetes medicines. It does not mean the tendency to diabetes has gone.
| Term | What it means | What follows |
|---|---|---|
| Complete remission | Sugar tests fully normal for a year or more, with no diabetes medicines | Yearly sugar tests for life |
| Partial remission | Sugar is below the diabetes range, but not fully normal, with no medicines | Sugar tests every few months |
| Improvement | Sugar is much better and tablets or insulin are cut, but not stopped | Doses reviewed at every visit |
| Little change | Sugar and medicines stay about the same | Other options are discussed |
A fair test is made at least three months after the last diabetes tablet or injection. A sugar that looks normal only because you are still on medicine does not count.
The sooner an operation is done after diabetes starts, and the more insulin your own body still makes, the better the chance. Nobody can promise it, but these signs help us advise you.
| Factor | Better chance | Lower chance |
|---|---|---|
| Years since diagnosis | A few years | Many years |
| Insulin injections | Tablets only | Long use of insulin |
| Insulin your body makes | Still plenty (a blood test called C-peptide shows this) | Very little |
| Sugar control before surgery | Fairly steady | Always high despite many medicines |
| Weight lost afterwards | Large, and kept off | Small, or regained |
| Age | Younger adults | Older adults |
Type 1 diabetes is a different disease. The body makes no insulin, and surgery does not change that. This post is about type 2 diabetes.
Indians often develop diabetes at a lower weight than Western patients. For an Asian patient with type 2 diabetes, surgery can be offered at a BMI of 27.5 to 32.5. This follows a written team discussion. Below that, the evidence is thin, and we do not operate for sugar alone.
Often within days, well before much weight is lost. This is why diabetes medicines have to be cut right away, and why the hospital team watches your sugar closely.
| When | What happens | What we do |
|---|---|---|
| First days | Sugar falls as food intake drops and gut hormones change | Insulin and tablets are reduced before you go home |
| First weeks | Sugar settles lower. Some people already need little or no medicine | You check sugar at home, and call us with the readings |
| Three to six months | Weight keeps falling. Many medicines are stopped by now | HbA1c and blood pressure tablets reviewed |
| One year | The picture is clear: remission, improvement or little change | The result is named and a yearly plan is written |
Do not stop or change any dose on your own. Low sugar after surgery is a real danger when old doses are continued.
A little. Bypass operations tend to lower sugar more strongly than a sleeve. But the safest operation for you is also decided by reflux, your family history and your vitamin habits.
The operations are compared fully on our bariatric and metabolic surgery page. The final choice is made together, after the tests.
Not always, and not by yourself. Some medicines stop in the first days, some are cut slowly, and a few stay. The aim is the fewest medicines that keep you safe.
You go home with a written plan for every diabetes medicine. If your sugar is outside the plan, you call us the same day.
It can. Diabetes is a long-term condition, and remission can slip away. When it does, it is usually after weight comes back, and it can be treated again.
Weight-loss injections, called GLP-1 medicines, are a real choice before surgery, instead of surgery, or after it. They can lower sugar too, but the effect may fade when they are stopped. Doctors also watch for gallstones with fast weight loss, as explained in our post on GLP-1 medicines and gallbladder stones.
Come with facts about your own diabetes. The surer your numbers, the more honest our advice can be. Surgery is a decision for the whole team, and the answer can also be not yet.
Surgery is also not suitable in some other cases. These are an untreated eating disorder, severe depression that is not controlled, and active alcohol or drug dependence. Saying no, or not now, is part of good care.
For many people with type 2 diabetes, sugar returns to normal without medicines. But diabetes can come back, mostly when weight returns. So we call it remission and keep testing every year, for life.
Often insulin is cut sharply in the first days, and some people stop it. This is decided by your team, not by you. People with many years of insulin use are less likely to stop it fully.
It can. For an Asian patient with type 2 diabetes, surgery can be offered from a BMI of 27.5 to 32.5. A written team discussion comes first. Below that level, we do not operate for sugar alone.
It can, sometimes after years. Weight regain is the usual reason. Yearly HbA1c tests catch it early, and it is treated again with diet, medicines or, rarely, another operation.
A gastric bypass tends to lower sugar more strongly than a sleeve. But reflux, family history of stomach cancer and your willingness to take vitamins also decide the choice. We pick the one that is safest for you.
Yes. Years of high sugar may already have caused changes in the eyes, kidneys and feet. Remission does not undo them, so these yearly checks continue.
No. Large weight loss by diet and activity, or with weight-loss injections, can also bring remission in some people. Surgery gives the most lasting weight loss, but it is one choice among several.
For the full range of weight-loss and metabolic surgery, start at the bariatric and metabolic surgery page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Living with type 2 diabetes and wondering whether an operation could bring your sugar back to normal? Dr Harsh Shah will look at your reports, tell you honestly how likely that is for you, and plan the next step with you. Call, or send a message on WhatsApp. Call +91-63555-64601 Ask on WhatsApp
Swasth Parivar: every week, practical advice on recovery, diet and warning signs. No advertising. Stop any time.
Your number is used for these updates and for the clinic to reach you. It is never sold or passed on. To stop, reply STOP on WhatsApp.