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Effectiveness of an Interprofessional Glycemic Optimization Clinic on Preoperative Glycated Hemoglobin Levels for Adult Patients With Type 2 Diabetes Undergoing Bariatric Surgery.
- Source :
-
Canadian journal of diabetes [Can J Diabetes] 2018 Oct; Vol. 42 (5), pp. 514-519. Date of Electronic Publication: 2017 Dec 26. - Publication Year :
- 2018
-
Abstract
- Objectives: Bariatric surgery is an effective treatment for patients with type 2 diabetes and refractory obesity; however, many patients have nonoptimal glycemic control preoperatively. We created an interprofessional bariatric glycemic optimization clinic. Patients were seen monthly and received weekly phone calls. We analyzed the effectiveness in assisting patients reach a preoperative glycated hemoglobin (A1C) level of <7.5%.<br />Methods: Data were analyzed for the first 75 patients. The primary outcome measure was percentage of patients reaching target A1C levels.<br />Results: Mean age was 51±8.3 years; 64% were women. Mean baseline weight was 134.4±29.2 kg. Baseline body mass index was 48.2±8.3 kg/m <superscript>2</superscript> . Duration of diabetes was 9±7.9 years. Baseline A1C level was 9.0±1.2%. Number of antihyperglycemic agents at baseline was 2.7±0.96. Seventy-five percent reached a target A1C level of ≤7.5%, 92% reached a target of ≤8.0% and 95% reached a target of ≤8.5%; 32% had achieved A1C levels ≤7.5% at 1 month, 59% at 2 months, 70% at 3 months, 73% at 4 months and 75% at 5 months. Mean number of antihyperglycemic agents at target A1C levels was 3.6±1.1. Mean absolute decrease in A1C levels from baseline to target A1C levels was 1.7±1.2. Mean absolute change in weight was -1.9±8.0 kg. Percent change in body weight from baseline to target A1C level was -1.3±4.9%.<br />Conclusions: Glycemic optimization for candidates with diabetes for bariatric surgery is possible in a short time by an interprofessional diabetes team and without weight gain. Further research is needed to determine whether better preoperative glycemic control improves bariatric surgery outcomes.<br /> (Copyright © 2018. Published by Elsevier Inc.)
- Subjects :
- Adult
Aged
Blood Glucose analysis
Blood Glucose metabolism
Calibration
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 drug therapy
Female
Glycated Hemoglobin analysis
Humans
Male
Middle Aged
Obesity blood
Obesity complications
Obesity drug therapy
Obesity surgery
Retrospective Studies
Treatment Outcome
Bariatric Surgery
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 surgery
Glycated Hemoglobin metabolism
Patient Care Planning organization & administration
Patient Care Planning standards
Patient Care Team organization & administration
Patient Care Team standards
Preoperative Care methods
Preoperative Care standards
Subjects
Details
- Language :
- English
- ISSN :
- 2352-3840
- Volume :
- 42
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Canadian journal of diabetes
- Publication Type :
- Academic Journal
- Accession number :
- 29530392
- Full Text :
- https://doi.org/10.1016/j.jcjd.2017.12.011