Perioperative medicine & outcomes
Characterization of trends in preoperative hemoglobin A1c testing prior to metabolic and bariatric surgery: a retrospective, observational study
Authors' conclusion
Despite society recommendations endorsing measurement of preoperative A1C prior to MBS, less than half of patients undergoing MBS between 2017 and 2022 received a preoperative A1C test. Additionally, there were differential patterns in testing based on diabetes status.
Study context
- Population
- Patients undergoing open, laparoscopic or robotic RYGB or sleeve gastrectomy, MBSAQIP database 2017–2022
- Participants
- 996,217 patients
- Exposure
- Preoperative A1c (A1C) tested vs not tested; diabetes status as predictor of testing
- Outcome
- Proportion of metabolic and bariatric surgery (MBS) patients receiving a preoperative A1C test
Methodological detailsobservational, registry database (MBSAQIP)
- Observational
- Registry database (MBSAQIP)
Main finding
As reported in the abstract
Receipt of preoperative A1C test
Overall received a preoperative A1C test
45.7%
Tested in 2017
35.5%
Tested in 2022
56.0%
Observational data: associations, not effects.
Further findings
| Outcome | aOR | P value |
|---|---|---|
| Receipt of A1C test by diabetes statusNon-insulin dependent diabetes vs No diabetes or diet-controlled | 1.77 | P < 0.001 |
| Receipt of A1C test by diabetes statusInsulin dependent vs No diabetes or diet-controlled | 2.13 | P < 0.001 |
- Receipt of A1C test by diabetes status: logistic regression adjusted for sociodemographic and clinical factors
Cardiopulmonary comorbidities, tested vs not tested
- COPD 1.4% vs 1.2%, p < 0.001
- PE 1.4% vs 1.2%, p < 0.001
- Sleep apnea 39.3 vs. 36.4%, p < 0.001
- HTN 47.1% vs 44.0%, p < 0.001
- MI 1.2% vs. 1.0%, p < 0.001
- Differences small and may not be clinically significant
Original publication
Characterization of trends in preoperative hemoglobin A1c testing prior to metabolic and bariatric surgery: a retrospective, observational study. Perioper Med (Lond). Published 10 January 2025. doi:10.
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