Preoperative Hypertension and Hypercholesterolemia Predict T2DM Persistence After Metabolic Surgery in Obese Patients

Spain: A recent study published in Diabetes Research and Clinical Practice has found that preoperative hypertension and hypercholesterolemia, along with longer diabetes duration and higher HbA1c concentrations, are independent predictors of type 2 diabetes (T2DM) persistence after metabolic surgery.

Metabolic surgery has been identified as the most effective therapeutic strategy for managing T2DM. However, little is known about the preoperative factors that may affect T2DM remission after metabolic surgery.

In a prospective study of 98 patients with T2DM undergoing metabolic surgery, researchers collected data on clinical, anthropometric, and biochemical parameters at baseline and 1 year following surgery.

The study concluded with the following clinical findings:

1. Patients without T2DM remission after metabolic surgery had a longer duration of diabetes and higher HbA1c levels.

2. Higher percentage of these patients were using insulin therapy, antihypertensive drugs, and lipid-lowering therapies before surgery compared to those who achieved T2DM remission.

3. Patients with hypertension or hypercholesterolemia before surgery had a lower percentage of T2DM remission after surgery.

4. Patients with longer diabetes duration also had a lower percentage of T2DM remission after surgery.

5. Diabetes duration, basal HbA1c, and the presence of hypertension and hypercholesterolemia before surgery were inversely related to T2DM remission following metabolic surgery, after adjusting for sex, age, waist circumference, and type of surgery in a logistic regression model.

The study’s findings suggest that patients with preexisting hypertension or hypercholesterolemia, as well as those with longer diabetes duration and higher HbA1c levels, may require more aggressive management strategies to achieve T2DM remission after metabolic surgery.

The researcher of the study added that “The study's results may also have implications for clinical practice, as they suggest that preoperative hypertension and hypercholesterolemia should be considered when selecting patients for metabolic surgery.”

Reference:

Martínez-Montoro, J. I., Generoso-Piñar, M., Ocaña-Wilhelmi, L., Gutiérrez-Repiso, C., Sánchez-García, A., Soler-Humanes, R., Fernández-Serrano, J. L., Sánchez-Gallego, P., Martínez-Moreno, J. M., García-Fuentes, E., Tinahones, F. J., & Garrido-Sánchez, L. (2023). Hypertension and hypercholesterolemia are predictive factors associated with type 2 diabetes persistence after metabolic surgery: A prospective study. Diabetes Research and Clinical Practice, 199, 110650. https://doi.org/10.1016/j.diabres.2023.110650