Background

Preoperative hyperglycemia may occur in patients undergoing metabolic surgery due to cessation of antidiabetic medications. This can result in cancellation of procedures intended to control type 2 diabetes mellitus (T2DM). We evaluated the association of mild, moderate, and severe hyperglycemia with 30-day adverse events following metabolic surgery.

Methods

A retrospective chart review of patients with T2DM and obesity undergoing metabolic surgery at a single MBSAQIP center over a four-year period was performed. We assessed the association between preoperative hyperglycemia and 30-day adverse events defined as readmissions, reoperation, transfer to ICU, or surgical site infection. Patients were categorized to four groups: euglycemic (<125 mg/dl), mild (126-180 mg/dl), moderate (181-240 mg/dl) and severe hyperglycemia (>240 mg/dl).

Results

Of 556 patients, 423 patients (76.1%) were female with a mean age of 50.4 years (18.5-69.9). The mean preoperative BMI was 50.2 kg/m2 (35.4-86.4) and mean hemoglobin A1c was 7.3% (4.9-14.0). The rate of adverse events was 8.7% in the euglycemic group, 13.2% in the mild group, 10.7% in the moderate group, and 17.4% in the severe group (no statistical difference, P = 0.343). The median preoperative glucose level of patients who did not experience adverse events (129 mg/dl) was not significantly different (P = 0.460) from patients who did (136 mg/dl).

Conclusions

Our study demonstrates that preoperative hyperglycemia is not associated with increased 30-day adverse events in patients undergoing metabolic surgery and should not be a stand-alone contraindication to proceeding with surgery intended to control T2DM.