The Importance of Glycaemic Control Before Bariatric Surgery: Preventing Microvascular and Metabolic Complications

Sankar, Adhithya; Mudaliar, Rajshekhar N.; Kochhar, Rupinder S.; Summers, Lucinda K. M.; Syed, Akheel A.; Majeed, Waseem

doi:10.1007/s11695-024-07119-2

OBES SURG

2024

DOI: 10.1007/s11695-024-07119-2

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The Importance of Glycaemic Control Before Bariatric Surgery: Preventing Microvascular and Metabolic Complications

Adhithya Sankar,

Rajshekhar N. Mudaliar,

Rupinder S. Kochhar

et al.

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2024

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The Effects of Preoperative Glycaemic Control (HbA1c) on Bariatric and Metabolic Surgery Outcomes: Data from a Tertiary-Referral Bariatric Centre in the UK

Wilmington,

Abuawwad,

Holt

et al. 2024

OBES SURG

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Background Current recommendations advocate the achievement of an optimal glucose control (HbA1c < 69 mmol/mol) prior to elective surgery to reduce risks of peri-and post-operative complications, but the relevance for this glycaemic threshold prior to Bariatric Metabolic Surgery (BMS) following a specialist weight management programme remains unclear. Methods We undertook a retrospective cohort study of patients with type 2 diabetes mellitus (T2DM) who underwent BMS over a 6-year period (2016-2022) at a regional tertiary referral following completion of a specialist multidisciplinary weight management. Post-operative outcomes of interest included 30-day mortality, readmission rates, need for Intensive Care Unit (ICU) care and hospital length of stay (LOS) and were assessed according to HbA1c cut-off values of < 69 (N = 202) and > 69 mmol/mol (N = 67) as well as a continuous variable. Results A total of 269 patients with T2D were included in this study. Patients underwent primary Roux en-Y gastric bypass (RYGB, n = 136), Sleeve Gastrectomy (SG, n = 124), insertion of gastric band (n = 4) or one-anastomosis gastric bypass (OAGB, n = 4). No significant differences in the rates of complications were observed between the two groups of pre-operative HbA1c cut-off values. No HbA1c threshold was observed for glycaemic control that would affect the peri-and post-operative complications following BMS. Conclusions We observed no associations between pre-operative HbA1C values and the risk of peri-and post-operative complications. In the context of a specialist multidisciplinary weight management programme, optimising pre-operative HbA1C to a recommended target value prior to BMS may not translate into reduced risks of peri-and post-operative complications.

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The Effects of Preoperative Glycaemic Control (HbA1c) on Bariatric and Metabolic Surgery Outcomes: Data from a Tertiary-Referral Bariatric Centre in the UK

Wilmington,

Abuawwad,

Holt

et al. 2024

OBES SURG

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The Importance of Glycaemic Control Before Bariatric Surgery: Preventing Microvascular and Metabolic Complications

Cited by 1 publication

References 17 publications

The Effects of Preoperative Glycaemic Control (HbA1c) on Bariatric and Metabolic Surgery Outcomes: Data from a Tertiary-Referral Bariatric Centre in the UK

The Effects of Preoperative Glycaemic Control (HbA1c) on Bariatric and Metabolic Surgery Outcomes: Data from a Tertiary-Referral Bariatric Centre in the UK

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