Background

A large number of patients undergoing weight loss surgery suffer from diabetes, which is a significant comorbidity of obesity. Due to complications of diabetes, these patients may be at higher risk when undergoing weight loss surgery. Our aim was to compare rates of complications in diabetic and non-diabetic patients, as well as insulin dependent (IDDM) vs non-insulin (NIDDM) dependent diabetic patients undergoing sleeve gastrectomy and gastric bypass.

Methods

MBSAQIP patient use files, 2015-2017 were queried for patients with diabetes and insulin use status undergoing bariatric surgery. Patient characteristics were analyzed using Chi-square test and logistic regression analysis. Significance was considered at p<0.05.

Results

555,239 patients had weight loss surgery. 16.5% of patients had diabetes and 8% of patients had IDDM (32.7% of diabetics). Differences between diabetic and non-diabetic patients are shown in Table 1. Overall complication rates in diabetics were low but diabetes was associated with increased rates of complications. Noted differences, were higher death rates, admission to ICU and readmission rates in diabetic patients for both procedures. Comparing IDDM vs NIDDM, significant differences were found in superficial and deep wound infections, wound disruption, renal failure, UTI, ICU admission, readmission and death.

Conclusions

Weight loss surgery is safe in patients with diabetes, but with higher complication rates, specifically, in mortality rate, readmission to hospital, and admission to ICU postoperatively. Patients with IDDM have even higher rates of these complications compared to NIDDM patients. Weight loss surgery should be offered to diabetic patients with awareness that complications may be higher.