Last updated July 15, 2026
Key finding
HOMA-IR decreased by 42.2% (p = 0.004)
This study compared the effects of pharmacological treatment, bariatric surgery, and a very-low-calorie diet on insulin resistance in patients with type 2 diabetes and hypertension, finding significant improvements in insulin resistance and weight loss with surgery and diet.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study compared the effects of pharmacological treatment, bariatric surgery, and a very-low-calorie diet on insulin resistance in patients with type 2 diabetes and hypertension, finding significant improvements in insulin resistance and weight loss with surgery and diet.
The findings highlight the potential of bariatric surgery and very-low-calorie diets as effective interventions for managing insulin resistance and weight in patients with type 2 diabetes and hypertension. This could inform treatment strategies and improve patient outcomes, emphasizing the need for tailored approaches in managing these chronic conditions.
The study's cohort design may limit causal inferences. Sample size and demographic diversity were not specified. Long-term effects of interventions were not assessed.
Published in
Publication details and source links for this paper.
Kuat O, Aigul D, Gani K, et al. Comparative Effects of Pharmacological Treatment, Bariatric Surgery, and Very-Low-Calorie Diet on Insulin Resistance in Patients with Type 2 Diabetes and Hypertension. Journal of Clinical Medicine. 2026;15(2):546. doi:10.3390/jcm15020546
Bariatric surgery reduced insulin resistance by 88.7% (p < 0.0001).
Very-low-calorie diet led to a significant weight loss of 17.4% (p < 0.0001).
Pharmacological treatment showed an insignificant weight loss of 6.5% (p = 0.06).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Bariatric surgery, Subcutaneous Semaglutide, Very-low-calorie ketogenic diet and Diastolic blood pressure, Insulin resistance, Systolic blood pressure, and 1 more.
This study contributes evidence to
Primary intervention
Bariatric surgery
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
3
Related topics
12
Evidence pairs
403
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence relationship
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Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Bariatric surgery → Diastolic blood pressure
Bariatric surgery → Diastolic blood pressure
Bariatric surgery → Systolic blood pressure
Bariatric surgery → Systolic blood pressure
Bariatric surgery → Weight loss of 10% or more at 52 weeks
Bariatric surgery → Weight loss of 10% or more at 52 weeks
Subcutaneous Semaglutide → Diastolic blood pressure
Subcutaneous Semaglutide → Diastolic blood pressure
Subcutaneous Semaglutide → Insulin resistance
Subcutaneous Semaglutide → Insulin resistance
Subcutaneous Semaglutide → Systolic blood pressure
Subcutaneous Semaglutide → Systolic blood pressure
Subcutaneous Semaglutide → Weight loss of 10% or more at 52 weeks
Subcutaneous Semaglutide → Weight loss of 10% or more at 52 weeks
Very-low-calorie ketogenic diet → Diastolic blood pressure
Very-low-calorie ketogenic diet → Diastolic blood pressure
Very-low-calorie ketogenic diet → Insulin resistance
Very-low-calorie ketogenic diet → Insulin resistance
Very-low-calorie ketogenic diet → Systolic blood pressure
Very-low-calorie ketogenic diet → Systolic blood pressure
Very-low-calorie ketogenic diet → Weight loss of 10% or more at 52 weeks
Very-low-calorie ketogenic diet → Weight loss of 10% or more at 52 weeks
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Ketogenic Diets and Insulin Resistance, Bariatric Procedures and Blood Pressure.
This study contributes to the evidence on the following intervention-outcome relationships.
Diet and Nutrition
Procedures
Diet and Nutrition
Curated evidence collections and hubs this study is part of.
All studies measuring Insulin Resistance
Measures Insulin Resistance as a key outcome.
All studies on Ketogenic Diets
Contributes to Ketogenic Diets evidence base.
All studies on Bariatric Procedures
Contributes to Bariatric Procedures evidence base.
All studies measuring Blood Pressure
Measures Blood Pressure as a key outcome.
All studies measuring Weight loss of 10% or more at 52 weeks
Measures Weight loss of 10% or more at 52 weeks as a key outcome.
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3 results
2 results
3 results
2 results
3 results
Generated from the study's connected evidence using Evidence Intelligence™.
Ketogenic Diets may improve Insulin Resistance.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Insulin resistance
EvidenceScore™ Strong | EvidenceScore™ 76.2 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 4 supporting studies with consistent results and a positive effect signal.
Limitations
Bariatric Procedures appears to improve Blood Pressure.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Diastolic blood pressure
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Systolic blood pressure
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a small number of supporting studies and should be interpreted cautiously.
Limitations
Bariatric Procedures appears to improve Insulin Resistance.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Insulin resistance
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Ketogenic Diets appears to improve Blood Pressure.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Diastolic blood pressure
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Systolic blood pressure
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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