Early outcome after laparoscopic sleeve gastrectomy of type two diabetes mellitus patients with extremely elevated glycated hemoglobin (HbA1c).
BACKGROUND
Due to high prevalence of type 2 diabetes mellitus (T2DM) and increasing popularity of bariatric and metabolic operations, Surgeons are faced with patients with relatively more severe T2DM disease. High level of glycated hemoglobin (HbA1c) is widely considered as a marker for uncontrolled T2DM. The aim of this study was to explore the correlation between high level of pre-operative HbA1c, peri-operative morbidity and post operative outcome after laparoscopic sleeve gastrectomy.


METHODS
We conducted a retrospective study based on our medical center metabolic and bariatric registry. The inclusion criteria for selecting patients to the study group was HbA1c of 9 gram/dL and higher. A comparison control study was designed to include T2DM patients similar in all characteristics except for HbA1c of 7.5 gram/dl and less.


RESULTS
We included 20 patients who underwent laparoscopic sleeve gastrectomy. Each group of patients included half of the patients. The mean pre operative HbA1c in the studied and the control group were 10.4 gram/dL and 7.1 gram/dL respectively (p<0.001). There were no differences in peri-operative morbidity and length of stay at the hospital. Mean excess weight loss, fasting glucose levels and HbA1c levels were similar six months post surgery mean.


CONCLUSIONS
According to our study we have not found correlation between high HbA1c levels and increased peri-operative morbidity or insufficient excess weight loss among patients who underwent laparoscopic sleeve gastrectomy.
Hadassah Hebrew University Medical Center, Department of Surgery, Ein Kerem Campus, Jerusalem, Israel. Electronic address: ramelazary@hadassah.org.il.
Ram
R
Elazary
Mahmoud
M
Abu-Gazala
Tair
T
Ben-Porat
Asaf
A
Kedar
Yoav
Y
Mintz
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome
D006442:Glycated Hemoglobin
Diabetes mellitus; Glycated hemoglobin; HbA1c; Outcome; Sleeve gastrectomy