Dicker D, et al. - Conversion rates to diabetes 5 years after three types of metabolic surgery were determined and predictors of diabetes development were investigated. From Clalit Health Services, data of 1,756 individuals with prediabetes, defined as fasting glucose (FG) 100–125 mg/dL (5.6–6.9 mmol/L) or HbA1c 5.7–6.4% at baseline (preoperatively), who underwent metabolic surgeries during 2002–2011, were retrieved. Gastric banding (GB) was performed on 819, sleeve gastrectomy (SG) on 845, and Roux-en-Y gastric bypass (RYGB) on 92. Diabetes developed in 177 (10.1%) five years post-surgery. By type of surgery, conversion rates of 14.4%, 6.3%, and 6.5% were reported for GB, SG, and RYGB, respectively. Weight loss during the first postoperative year and preoperative levels of both FG and HbA1c within the prediabetes range were the predictive factors for diabetes development 5 years postoperatively. These findings highlight that for the long-term prevention of diabetes in patients with prediabetes undergoing metabolic surgery, preoperative glycemic control and weight loss during the first year postoperatively are significant.