Rebekah Wilmington
The Effects of Preoperative Glycaemic Control (HbA1c) on Bariatric and Metabolic Surgery Outcomes: Data from a Tertiary-Referral Bariatric Centre in the UK
Wilmington, Rebekah; Abuawwad, Mahmoud; Holt, Guy; Anderson, Robyn; Aldafas, Rami; Awad, Sherif; Idris, Iskandar
Authors
Mahmoud Abuawwad
Guy Holt
Robyn Anderson
Rami Aldafas
Sherif Awad
ISKANDAR IDRIS Iskandar.Idris@nottingham.ac.uk
Professor of Diabetes and Metabolic Medicine
Abstract
Background: Current recommendations advocate the achievement of an optimal glucose control (HbA1c < 69mmol/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 > 69mmol/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.
Citation
Wilmington, R., Abuawwad, M., Holt, G., Anderson, R., Aldafas, R., Awad, S., & Idris, I. (2024). The Effects of Preoperative Glycaemic Control (HbA1c) on Bariatric and Metabolic Surgery Outcomes: Data from a Tertiary-Referral Bariatric Centre in the UK. Obesity Surgery, 34, 850-854. https://doi.org/10.1007/s11695-023-06964-x
Journal Article Type | Article |
---|---|
Acceptance Date | Nov 14, 2023 |
Online Publication Date | Jan 15, 2024 |
Publication Date | 2024-03 |
Deposit Date | Nov 16, 2023 |
Publicly Available Date | Jan 16, 2025 |
Journal | Obesity Surgery |
Print ISSN | 0960-8923 |
Electronic ISSN | 1708-0428 |
Publisher | Springer Verlag |
Peer Reviewed | Peer Reviewed |
Volume | 34 |
Pages | 850-854 |
DOI | https://doi.org/10.1007/s11695-023-06964-x |
Keywords | Bariatric surgery; Type 2 diabetes; Glycated Haemoglobin; HbA1c; peri- operative; post operative; complications; mortality; Intensive care; Length of stay |
Public URL | https://nottingham-repository.worktribe.com/output/27375315 |
Publisher URL | https://link.springer.com/article/10.1007/s11695-023-06964-x |
Additional Information | Received: 27 September 2023; Revised: 14 November 2023; Accepted: 14 November 2023; First Online: 15 January 2024; : ; : Retrospective study. For this type of study, formal consent is not required.; : This was a retrospective study. Informed consent does not apply.; : The authors declare no competing interests. |
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