Type 2 Diabetes and HbA1c Predict All-Cause Post-Metabolic and Bariatric Surgery Hospital Readmission

Obesity (Silver Spring). 2021 Jan;29(1):71-78. doi: 10.1002/oby.23044. Epub 2020 Nov 20.

Abstract

Objective: The main goal of this analysis was to determine whether type 2 diabetes and hemoglobin A1c (HbA1c) predict all-cause 30-day hospital readmission after metabolic and bariatric surgery (MBS). It was hypothesized that a diagnosis of type 2 diabetes or high HbA1c values would predict all-cause hospital readmission rates post MBS.

Methods: A retrospective analysis from the 2015-2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) cohort was completed (N = 744,776); 30,972 participants were readmitted during the 30 days post MBS.

Results: Mean age of the MBSAQIP sample was 45.1 (11.5) years, and the majority were female (80.7%) and non-Hispanic White (59.4%). The all-cause hospital readmission rate was 4.2% and increased by 10% in those with uncontrolled type 2 diabetes (HbA1c > 7.5% [> 58 mmol/mol]); after adjustment, diabetes was not associated with increased readmission. Uncontrolled type 2 diabetes, type 2 diabetes, and prediabetes resulted in less weight loss 30 days post MBS.

Conclusions: These results based on a national MBS cohort showed that uncontrolled type 2 diabetes is associated with a greater likelihood of all-cause hospital readmission and reduced weight loss 30 days post MBS. Both type 2 diabetes and prediabetes were also associated with decreased weight loss 30 days post MBS. These findings highlight the need to classify and optimize glycemic control prior to MBS.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Bariatric Surgery*
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Glycated Hemoglobin / analysis*
  • Glycemic Control
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Patient Readmission*
  • Prediabetic State / complications
  • Retrospective Studies
  • Weight Loss

Substances

  • Glycated Hemoglobin A