Cohort studycited by the Tayebat archiveabstract only checked★ key study A-BAR-23 in-depth review
SOS: diabetes after 15 years
Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications.
Overview
Sjöström L et al.. JAMA 2014 · PMID 24915261 · DOI 10.1001/jama.2014.5988
Remission fell from 72% at 2 years to 30% at 15 years after surgery (controls: 16% to 6.5%); diabetes complications were about halved.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Diabetes long-term
- How was the study done?
Prospective matched cohort
- How many people, animals or samples were studied?
603 with T2D
- What was actually found?
Remission declines; complications fewer
- How large was the observed effect?
OR 6.3 at 15 y; HR 0.44 microvascular
- What do the results mean in everyday life?
Relapse is common, but surgery still did better than usual care
- What are the study's limitations?
Attrition; non-randomized
- What does it say about Elawady's specific claim?
Relapse true; 'collapse' framing incomplete
- Do the results apply to Germany and Europe?
European
- What can explicitly not be concluded from this study?
Effect of modern procedures
Scientific in-depth review
1. Full reference
- Authors
- Sjöström L, Peltonen M, Jacobson P, Ahlin S, Andersson-Assarsson J, Anveden Å, Bouchard C, Carlsson B, Karason K, Lönroth H, Näslund I, Sjöström E, Taube M, Wedel H, Svensson PA, Sjöholm K, Carlsson LM
- Journal
- JAMA
- Year
- 2014
- Identifier
- PMID 24915261 DOI 10.1001/jama.2014.5988
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
COI: not stated in record | Grants: none listed
2. Research question
Long-term diabetes remission and complications after bariatric surgery
3. Study design and population
- Study design
- Cohort study – Prospective matched cohort (SOS), diabetes subgroup
- Population
SOS participants with T2D at baseline
- Country
Sweden
- Period
1987-2013
- Sample size
343 surgery, 260 controls with T2D
- Inclusion and exclusion criteria
Participation at 15-year exam: 47% surgery, 41% controls
4. Methods and endpoints
- Exposure / intervention
Banding, VBG, gastric bypass
- Comparator
Usual care
- Endpoints
Remission (glucose <110 mg/dL, no medication), complications
- Statistical methods
OR, HR
5. Actual results
- Results
Remission at 2 years 72.3% (219/303) surgery vs 16.4% control (OR 13.3); at 15 years 30.4% (35/115) vs 6.5% (4/62) (OR 6.3). Microvascular complications 20.6 vs 41.8 per 1000 PY (HR 0.44); macrovascular 31.7 vs 44.2 (HR 0.68).
- Absolute risks
Microvascular complications halved (20.6 vs 41.8 per 1000 PY)
- Authors' conclusion
Surgery associated with more frequent remission and fewer complications than usual care; requires confirmation in RCTs.
6. Strengths
- Very long follow-up
- Complication data from registers
7. Weaknesses
- Low participation at 15 years (41-47%)
- Non-randomized
- Old procedures
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
Central for C-BAR-08.
11. Independent contrary findings
Mingrone (I-BAR-03), ARMMS (I-BAR-02) show sustained superiority over medical therapy.
12. Transferability to Germany and Europe
Directly European.
13. Overall methodological judgement
Correct numbers, selective framing; AR headline misinterprets the denominator.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | partly correct but over-interpreted |
14. Open questions
15. Linked fact checks
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
SOS 15-year diabetes remission fell to just 30.4%; complications were reduced but not eliminated. AR headline: of SOS patients whose diabetes initially remitted, the majority relapsed; only 30.4% maintained remission after 15 years.
- A. What was actually studied?
Diabetes remission and complications
- B. What did the authors find?
72.3% -> 30.4% remission (controls 16.4% -> 6.5%); complications reduced (HR 0.44, 0.68)
- C. What conclusions do the authors themselves draw?
Surgery associated with more remission and fewer complications
- D. What does the archive derive from it?
Used to show remission 'collapses'.
- E. Is this derivation scientifically justified?
Numbers correct, but: (1) the AR headline misstates 30.4% as the share of initially remitted patients who stayed in remission; it is the remission rate among surgical patients examined at 15 years; (2) the control rates (6.5%) and the halving of microvascular complications are not given equal weight.
- Adequacy of the interpretation (by the archive)
- partly correct but over-interpreted