Assessment of glycosylated hemoglobin as a routine preoperative investigation in bariatric surgery: an Egyptian experience

Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health. Besides being a worldwide public health problem, obesity is a major risk factor for a number of noncommunicable diseases, including diabetes, cardiovascular diseases, and cancer. Once considered a problem only in high-income countries, overweight and obesity are now dramatically on the rise in low-income and middle-income countries, particularly in urban settings. In Egypt, obesity prevalence is on the rise. Weight loss or bariatric surgeries are gaining more and more popularity as a surgical solution to tackle obesity. This is a cross-sectional study conducted at a specialized center of bariatric surgery for 1-year period on 396 patients who underwent bariatric surgeries (sleeve gastrectomy, OAGB) with age range from 15 to 64 years and BMI range from 32 to 76 kg/m2. All surgical procedures were performed by the same bariatric surgical team. Postoperative follow-up consisted of visits with a multidisciplinary team, including the surgeon, physician assistant, and registered dietitian, at 3 weeks, 3, 6, 9, 12 months, and then yearly. The role of surgery in the treatment of diabetes is evolving. A noteworthy reduction in glycosylated hemoglobin (HbA1c) levels at postoperative was noted in diabetic patients. Our study suggests a relation between HbA1c levels and BMI. This relation states that reduction in BMI (i.e. tackling obesity) leads to reduction in HbA1c. It is of paramount importance to assess the long-term clinical outcomes of the surgical weight loss interventions. Obesity-related comorbidities should be evaluated in depth.