Preoperative glycemic control and postoperative clinical outcomes in patients with type 2 diabetes mellitus undergoing bariatric surgery

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-02-26 DOI:10.1016/j.clnesp.2025.02.016

Bárbara Brambilla , Carina Andriatta Blume , Taíse Rosa de Carvalho , Janine Alessi , Beatriz D. Schaan

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引用次数: 0

Abstract

Background

The preoperative glycated hemoglobin (HbA1c) cutoff point for elective surgery in patients with type 2 diabetes mellitus (T2DM) remains unclear, as does its association with postoperative outcomes, especially in patients undergoing bariatric surgery.

Methods

We conducted a retrospective cohort study including patients with T2DM and an electronic record of HbA1c within the four months prior to surgery who underwent Roux-en-Y gastric bypass (RYGB) from August 2010 to May 2019. The primary outcome was postoperative hospital length of stay (LOS), and secondary outcomes included need for intensive care, clinical outcomes (pulmonary, cardiovascular, septic), and surgical wound complications. These outcomes were assessed using an HbA1c cutoff value of 7 %. Comparisons were made using the Mann–Whitney U test and a general linear model adjusting the primary outcome for confounders and for differences in baseline characteristics between groups.

Results

A total of 114 individuals were divided into two groups according to HbA1c: ≤7 % (N = 63) or > 7 % (N = 51). No differences were observed between the groups in terms of LOS (4 vs 5 days, p = 0.28) and clinical or operative wound complication rates. Alternative HbA1c cutoff points (7.5 %, 8 %, and 8.5 %) were also evaluated for LOS, with no change in results.

Conclusion

Bariatric surgery should not be postponed in patients with T2DM based on an HbA1c greater than 7 %, as LOS, clinical outcomes and operative wound complication rates are not worse in patients with poorer glucose control based on this criterion.

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接受减肥手术的 2 型糖尿病患者的术前血糖控制和术后临床效果。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.