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Diabetes: Symptoms, Diagnosis, and Complications01:15

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Related Experiment Video

Updated: Oct 5, 2025

Sleeve Gastrectomy in Mice using Surgical Clips
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Elevated hemoglobin A1c level and bariatric surgery complications.

Ugoeze Nwokedi1, Mahnoor Zia1, Jiaqiong Xu2

  • 1Department of Surgery, Houston Methodist Hospital, 6550 Fannin Street, Smith Tower SM1661, Houston, TX, 77030, USA.

Surgical Endoscopy
|January 25, 2022
PubMed
Summary

Elevated glycosylated hemoglobin (HbA1c) levels above 8% did not increase postoperative complications in bariatric surgery patients. However, HbA1c below 10% was linked to some adverse outcomes, warranting further investigation.

Keywords:
BariatricComplicationsGastric bypassHemoglobin A1cSleeve gastrectomy

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Area of Science:

  • Metabolic Surgery
  • Surgical Outcomes Research
  • Diabetes Management

Background:

  • Elevated glycosylated hemoglobin (HbA1c) is a known risk factor for complications in cardiac and orthopedic surgery.
  • Limited evidence exists regarding the impact of preoperative HbA1c on postoperative outcomes in bariatric surgery.

Purpose of the Study:

  • To evaluate the association between preoperative HbA1c levels and early postoperative complications in patients undergoing bariatric surgery.
  • To determine if elevated HbA1c is a significant predictor of adverse outcomes post-bariatric procedures.

Main Methods:

  • Retrospective analysis of 118,742 patients undergoing laparoscopic sleeve gastrectomy or Roux-En-Y Gastric Bypass (2017-2018) from the MBSAQIP database.
  • Patients were grouped by HbA1c cutoffs (≤8% vs >8% and ≤10% vs >10%).
  • Propensity score matching (PSM) was utilized to balance covariates, followed by statistical analysis of complication rates.

Main Results:

  • After PSM, elevated HbA1c (>8%) was not significantly associated with increased composite postoperative complications (p=0.22).
  • Patients with HbA1c ≤10% showed more composite complications compared to those with HbA1c >10% (p<0.001).
  • Subgroup analysis for sleeve gastrectomy and gastric bypass did not reveal worsened outcomes for HbA1c >8%, but HbA1c ≤10% was linked to more complications.

Conclusions:

  • Preoperative HbA1c levels >8% or >10% were not associated with increased postoperative complications in this bariatric surgery cohort.
  • HbA1c levels below 10% were associated with certain adverse outcomes, suggesting a complex relationship.
  • Elevated HbA1c alone may not be a contraindication for bariatric surgery, but further research is needed.