Hypertension and hypercholesterolemia are predictive factors associated with type 2 diabetes persistence after metabolic surgery: A prospective study

• Published in: Diabetes research and clinical practice Vol. 199; p. 110650
• Main Authors: Martínez-Montoro, José Ignacio, Generoso-Piñar, Marta, Ocaña-Wilhelmi, Luis, Gutiérrez-Repiso, Carolina, Sánchez-García, Ana, Soler-Humanes, Rocío, Fernández-Serrano, José Luis, Sánchez-Gallego, Pilar, Martínez-Moreno, José M., García-Fuentes, Eduardo, Tinahones, Francisco J., Garrido-Sánchez, Lourdes
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2023
• Subjects: Bariatric Surgery; Blood Glucose - metabolism; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - surgery; Diabetes remission; Dyslipidemia; Glycated Hemoglobin; Glycemic control; Humans; Hypercholesterolemia; Hyperlipidemias; Hypertension; Hypertension - complications; Metabolic surgery; Obesity, Morbid - complications; Prospective Studies; Remission Induction; Treatment Outcome; Type 2 diabetes; Type 2 diabetes; Hypertension; Glycemic control; Diabetes remission; Metabolic surgery; Dyslipidemia
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2023.110650

Metabolic surgery is the most effective therapeutic strategy for the management of type 2 diabetes (T2DM). Several preoperative clinical factors have been associated with T2DM remission after metabolic surgery. However, other potential predictors remain unexplored. To assess the role of basal (pre-surgery) clinical and biochemical parameters in T2DM remission after metabolic surgery. A prospective study including 98 patients with T2DM undergoing metabolic surgery was performed. Clinical, anthropometric, and biochemical data were collected at baseline and 1 year following metabolic surgery. Patients without T2DM remission 1 year after metabolic surgery presented a longer duration of diabetes and higher glycated hemoglobin (HbA1c) levels; a higher percentage of these subjects were using insulin therapy, antihypertensive drugs, and lipid-lowering therapies before metabolic surgery, compared to those patients with T2DM remission. A lower percentage of T2DM remission after metabolic surgery was observed among patients with hypertension/hypercholesterolemia before surgery, compared to those patients without hypertension/hypercholesterolemia (51.7 % vs 86.8 %, p < 0.001, and 38.5 % vs 75 %, p < 0.001, respectively), and among patients with longer duration of diabetes (≥5 years vs <5 years; 44.4 % vs 83 %, respectively; p < 0.001). In the logistic regression model, 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 cohort of patients with obesity and T2DM, preoperative hypertension and hypercholesterolemia, together with a longer diabetes duration and higher HbA1c concentrations, were independent predictors of T2DM persistence after metabolic surgery.