Hokkaido study links muscle to diabetes remission

Hokkaido University Hospital researchers reported on April 29 that skeletal muscle status before and after laparoscopic sleeve gastrectomy was associated with type 2 diabetes outcomes in a retrospective Japanese study. The paper, published in *Biomedical Reports*, reviewed 90 patients treated at the Sapporo hospital between October 2016 and February 2024 and tracked weight loss, obesity-related conditions and skeletal muscle mass measured by bioelectrical impedance analysis. At six months after surgery, median total weight loss was 21% and median excess weight loss was 52%, according to the abstract. The authors said the group with type 2 diabetes remission generally had higher skeletal muscle mass or percentage before and after surgery than patients without remission. ### Which patients were included in the Hokkaido review? The Hokkaido University Hospital team analyzed 90 patients who underwent laparoscopic sleeve gastrectomy for severe obesity, according to the study abstract. The surgeries were performed from October 2016 through February 2024 at the hospital in Sapporo, Japan, and the analysis focused on perioperative outcomes and factors associated with diabetes remission after surgery. (pubmed.ncbi.nlm.nih.gov) PubMed lists Hironobu Takano, Yuma Ebihara, Yuki Oe, Hideyuki Wada, Takeo Nitta, Akinobu Nakamura, Toshiaki Shichinohe and Satoshi Hirano as authors. Their listed affiliations include the Department of Gastroenterological Surgery II and the Department of Rheumatology, Endocrinology and Nephrology at Hokkaido University Hospital, as well as NTT Sapporo Medical Center. ### What did the study report on diabetes after surgery? (pubmed.ncbi.nlm.nih.gov) The study abstract said the rate of remission and improvement of type 2 diabetes was 75% at six months after surgery. EMJ’s May 13 report, which summarized the paper, said type 2 diabetes remission occurred in about 60% of cases and rose to 75% when remission and improvement were combined. Among patients with type 2 diabetes and at least one year of follow-up, EMJ reported that 35 achieved remission and 16 did not, while five were excluded from that analysis because postoperative follow-up was shorter than one year. (pubmed.ncbi.nlm.nih.gov) The original abstract available through PubMed does not provide those subgroup counts, but it does say remission patients generally had higher skeletal muscle mass or percentage through the preoperative and postoperative period. ### What muscle measurements were linked to remission? The authors said skeletal muscle mass was assessed by bioelectrical impedance analysis. The abstract reported that patients who achieved remission generally had significantly higher skeletal muscle mass or percentage throughout the preoperative and postoperative period, with differences reported at a statistical significance threshold of P<0.05. (pubmed.ncbi.nlm.nih.gov) EMJ reported that univariate analyses identified duration of diabetes treatment, body fat percentage, muscle mass and skeletal muscle mass as factors associated with remission. EMJ also said skeletal muscle mass did not remain a statistically significant independent predictor after adjustment for established clinical factors, a point the outlet said meant the association should not be read as causal on its own. (pubmed.ncbi.nlm.nih.gov) ### Why did the authors focus on skeletal muscle at all? The *Biomedical Reports* abstract said skeletal muscle plays an essential role in energy metabolism and whole-body glucose homeostasis, and that diabetes decreases insulin-induced glucose uptake in skeletal muscle. That rationale framed the study’s attempt to examine whether muscle status before and after surgery tracked with diabetes outcomes after sleeve gastrectomy. (emjreviews.com) The paper did not establish that preserving muscle causes remission. EMJ said the study’s retrospective design, small sample size, short follow-up and use of bioelectrical impedance analysis limited interpretation, and noted that postoperative muscle measurements may be affected by hydration status and fluid shifts. ### What comes next after this paper? EMJ reported on May 13 that further studies with longer follow-up are needed to determine whether targeted rehabilitation or resistance exercise before and after surgery can improve glycemic outcomes in patients undergoing laparoscopic sleeve gastrectomy. (pubmed.ncbi.nlm.nih.gov) The peer-reviewed article appeared in *Biomedical Reports* on April 29, 2026, with DOI 10.3892/br.2026.2152, and the PubMed record lists it in the journal’s June 2026 collection. (emjreviews.com)