title: A retrospective review of the medical management of hypertension and diabetes mellitus following sleeve gastrectomy.
abstract: BACKGROUND
  Bariatric surgery is being performed with increasing frequency in the USA as a definitive treatment for morbid obesity and associated comorbidities. Management strategies of type 2 diabetes mellitus (T2DM) and hypertension (HTN) medications in sleeve gastrectomy (SG) patients postoperatively are unclear, specifically in the immediate postoperative period and 6 months following surgery.
  
  
  METHODS
  From 01 June 2010 to 30 June 2011, at a single military medical facility, a retrospective review of 88 consecutive SG patients was conducted to examine the postoperative medical management of HTN and T2DM. Patient's HTN and T2DM medication regimens were evaluated for 6 months postoperatively. Categorical data was analyzed using chi-square, and continuous data was compared using the Student t test. Statistical analyses were completed with Stata, version 12.
  
  
  RESULTS
  Fifty patients were prescribed an average of 2.21 HTN medications at baseline which was reduced to an average of 1.23 (p < 0.01) medications per patient at 1 month. Twenty-four patients received an average of 1.41 oral T2DM medications with a reduction to 0.70 (p < 0.01) on average at 1 month postoperatively. Medication changes persisted throughout the 6-month follow-up. Among T2DM patients requiring insulin therapy, the mean insulin dose was 42.1 units reduced to 16.8 units immediately postoperatively (p < 0.01) which persisted at 1 month. At 6 months, the mean insulin dose was 13.3 units.
  
  
  CONCLUSIONS
  Medication adjustments for HTN and T2DM made immediately in the postoperative period following SG persisted throughout the 6-month follow-up period and in some patients, required further adjustments.
authors: Eisenhower Army Medical Center, 300 Hospital Rd, Ft. Gordon, GA, 30905, USA, adam.m.tritsch.mil@mail.mil.
authors: Adam M
authors: AM
authors: Tritsch
authors: Christopher M
authors: CM
authors: Bland
authors: Christos
authors: C
authors: Hatzigeorgiou
authors: Lori B
authors: LB
authors: Sweeney
authors: Michael
authors: M
authors: Phillips
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D015431:Weight Loss
chemical_list: D000959:Antihypertensive Agents; D007328:Insulin
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