{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:33:05Z","timestamp":1790249585211,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Type 2 diabetes (T2D) is characterized by its clinical heterogeneity. Newly described T2D subphenotypes, each with distinct metabolic and co\u2010morbidity risk profiles, may enable a more personalized care. This study examined whether these subphenotypes can predict outcomes in patients undergoing metabolic and bariatric surgery (MBS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A total of 233 people with T2D from four clinical centres undergoing MBS were retrospectively assigned to T2D subphenotypes based on the Ahlqvist methodology. The primary outcome was T2D remission at 2\u2009years; secondary outcomes included changes in HOMA2\u2010%B, HOMA2\u2010IR, and total body weight loss (%TWL). Intraoperative liver biopsies were evaluated for metabolic dysfunction\u2010associated steatotic liver disease (MASLD) and steatohepatitis (MASH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All participants were classified as mild obesity\u2010related diabetes (MOD) (62.2%), severe insulin\u2010resistant diabetes (SIRD) (19.7%), or SIDD (18.1%). At 2\u2009years, diabetes remission was lower in severe insulin\u2010deficient diabetes (SIDD) (36.7%) than MOD (79.3%) and SIRD (97.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). SIDD had lower BMI (38.3 vs. 45.2 and 43.2\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and worse beta\u2010cell function (HOMA2\u2010%B, 92.4 vs. 131.5 vs. 164;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), with highest HOMA2\u2010IR in SIRD (6.0\u2009\u00b1\u20093.4 vs. 4.4\u2009\u00b1\u20092.8 vs. 3.6\u2009\u00b1\u20091.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). %TWL was similar across subphenotypes. SIDD showed higher baseline MASH prevalence (60.5% vs. 46.3% vs. 46.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>T2D subphenotypes respond differently to T2D remission after MBS with SIDD showing a significantly lower remission rate than MOD and SIRD at 2\u2009years. Considering metabolic status in treatment decisions may improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70547","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:23:35Z","timestamp":1773030215000},"page":"3681-3691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Type 2 diabetes subphenotypes are associated with differential outcomes after metabolic and bariatric surgery: An international multicentre retrospective cohort study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2378-7048","authenticated-orcid":false,"given":"Adisa","family":"Poljo","sequence":"first","affiliation":[{"name":"Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel St. Clara Hospital and University Hospital Basel  Basel Switzerland"},{"name":"Medical Faculty Johannes Kepler University Linz  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