Preop hypertension, hypercholesterolemia foretell T2DM persistence after metabolic surgery

For patients with obesity and type 2 diabetes mellitus (T2DM) who are scheduled to undergo metabolic surgery, the presence of hypertension and hypercholesterolemia at baseline may predict failure of T2DM remission after the procedure, according to a study.

The prospective study included 98 patients with T2DM receiving metabolic surgery. Anthropometric, clinical, and biochemical parameters were assessed at baseline and 1 year after the surgical procedure.

Results showed that patients who did not achieve T2DM remission 1 year after metabolic surgery had a longer duration of diabetes and higher glycated haemoglobin (HbA1c) levels compared with those who achieved T2DM remission.

Additionally, the patients with T2DM persistence were more likely to have been using insulin therapy, blood pressure-lowering medications, and lipid-lowering therapies before metabolic surgery.

Of note, patients who had hypertension and hypercholesterolemia before their surgical procedure were less likely to achieve postoperative T2DM remission compared with those without hypertension and hypercholesterolemia (51.7 percent vs 86.8 percent; p<0.001 and 38.5 percent vs 75 percent; p<0.001). The same was true among patients with longer vs shorter duration of diabetes (≥5 years vs <5 years; 44.4 percent vs 83 percent; p<0.001).

Multivariable logistic regression analysis indicated that factors such as diabetes duration, basal HbA1c, and the presence of hypertension and hypercholesterolemia before surgery were inversely associated with postoperative T2DM remission.