Effect of Optimized Pre-Operative Glycemic Status on Diabetes and Body Composition After One Anastomosis Gastric Bypass in 373 Patients Publisher



Zamaninour N¹ ; Ansar H^{1, 4} ; Pazouki A^{1, 2} ; Zadeh MH³ ; Kabir A¹
Source: Indian Journal of Surgery Published:2022

Abstract

The effects of blood glucose and hemoglobin A1C [HbA1C] levels before one anastomosis gastric bypass surgery (OAGB) on post-operative fasting blood sugar (FBS), HbA1C, and body composition (BC) are not adequately studied. This study assessed optimized pre-operative hyperglycemia management on BC and glycemic factors after OAGB. This single-center study included 373 patients with type 2 diabetes who underwent OAGB (294 women), with 6, 12, and 24 months post-operative follow-up. The National Obesity Surgery Database provided data. To investigate the trend of changes in FBS, HbA1C, and BC data between two groups of controlled and uncontrolled diabetes during the study, the generalized estimating equations were used. Of total participants, 27.3% (n = 102) had controlled diabetes before surgery. After adjusting for age, sex, anti-hyperglycemic medication, and biliopancreatic limb length, patients with controlled diabetes pre-surgery showed significantly lower FBS (β coefficient: − 28.92; 95%CI: − 33.98 to − 23.85) and HbA1C (β coefficient: − 1.06; 95%CI: − 1.26 to − 0.86) than those with uncontrolled diabetes post-operative follow-up time points. However, there was no significant difference in total percentage weight loss, visceral fat, muscle and fat mass (P > 0.05) between groups after surgery. Pre-operative diabetes control significantly affects post-OAGB diabetes status, but not body composition values. © 2022, Association of Surgeons of India.