The Utilization of Bariatric Surgery in Patients with and without Diabetes: Results from the Second Kuwait National Bariatric Surgery Database Report

Abstract BackgroundDuring the year 2021, we were able to create the second Kuwait National Bariatric Surgery Database Report, which we used to extract data on the status and outcomes of patients presenting with type 2 diabetes mellitus (T2DM) undergoing bariatric-metabolic surgery in Kuwait. MethodsData was collected from seven public hospitals in Kuwait, and submitted to be merged in the National Registry. Cross-sectional analysis was then conducted. ResultsAll seven hospitals contributed to the submission of data. The rate of T2DM was 12.5% (607 patients), of which 69% were female. The mean age of patients with T2DM was higher than that of patients without (42 years vs 31.9 years). The overall BMI was slightly higher for patients with T2DM (mean 43.4kg/m2 vs 43.1kg/m2). The majority of patients with T2DM were in the BMI range 40.0-49.9kg/m2. Laparoscopic sleeve gastrectomy accounted for 79.0% of all procedures performed in non-diabetic patients and 79.7% of those performed in diabetic patients. When looking at surgical procedure distribution when classified according to starting BMI group in diabetic patients, it was interesting to see that, in Group 1 (BMI 35), sleeve gastrectomy accounted for 82.6-83.2% of all procedures performed. When comparing post-op compilations between diabetic vs non-diabetic patients, the percentage of overall complications encountered did not show a significant difference (1.81% vs 2.10% ; p=0.602). When looking at cardiovascular complications, patients with diabetes tended to present with higher post-op cardiac complications compared to non-diabetics (p=0.000).ConclusionLaparoscopic sleeve gastrectomy was the most performed procedure in both diabetics and non diabetics alike. Patients with diabetes tended to present for surgery at an older age than those without. It was interesting, albeit possibly expected, to note that patients with diabetes presented with a higher percentage of a multitude of complications post-operatively, pointing towards the importance of post-operative care in diabetic patients that present for bariatric surgery.