Hypoglycemia among bariatric surgery patients in national guard - health affairs, Riyadh, Saudi Arabia

Abstract

Background: In the last decade, bariatric surgery has shown better outcomes in reducing weight, especially in the long term, with a very low rate of significant complications. This study aims to estimate the rate of weight loss and to assess the changes in metabolic factors and the prevalence of hypoglycemia as a possible complication for post-bariatric surgery patients among patients in a single tertiary hospital in Saudi Arabia. Methods: A cross-sectional study was carried out with a nonprobability consecutive sampling technique involving 248 post-bariatric patients recruited between 1st January 2016 and 31st December 2018. Data were collected through the BESTCare system by a chart review and were reported as the rate of weight loss and post-surgical hypoglycemia. Results: Of the 248 patients who underwent bariatric surgery, 210 had successful weight loss. About 213 (96.8%) did not develop hypoglycemia. The metabolic factors that significantly changed after the surgery were BMI with a mean difference of 14.1 ± 6.3 kg/m2 p < 0.001, HbA1c 1.1 ± 1.6 mmol/mol p < 0.001, HDL -0.2 ± 0.3 mmol/l p < 0.001, random glucose 0.9 ± 2.6 mmol/l p < 0.001, systolic blood pressure 4.9 ± 18.8 mmHg p < 0.001, and diastolic blood pressure 3.0 ± 12.5 mmHg p < 0.001. Males had a greater weight loss with a mean of 44.2 ± 20.4 kg p < 0.001 in the age group between 18 and 30 years 42.8 ± 17.4 kg p < 0.001. The most significant weight reduction was between 21 and 30 months post surgery with a mean of 40.9 ± 16.8 kg p < 0.001. Conclusion: Gastric sleeves resulted in a high weight reduction rate, reflecting better lipid profile, blood pressure, and glycemic control outcomes. Weight reduction was higher in males between 18 and 30 years after 21-30 months postoperatively.