Attitudes and Concerns of Diabetic Patients towards Bariatric Surgery as Treatment of Diabetes

Abstract

Introduction: Bariatric surgery is increasingly recognised as an effective treatment for type 2 diabetes that significantly improves glycaemic control, even achieving remission. This study examined perceptions and concerns of diabetic patients towards bariatric surgery as a treatment option for diabetes. Materials and Methods: A total of 150 patients were recruited from a specialised diabetic outpatient clinic and completed a questionnaire (items were rated on a Likert scale from slightly important [lowest score of 1] to extremely important [maximum score of 5]). Logistic regression was performed to identify factors influencing decision for surgery. Results: The 74 males and 76 females had mean age of 50 (range 20 to 78) and body mass index (BMI) of 29.6 kg/m2 (range 18.1 to 51); 61% considered surgery favourably. Predictive factors for interest in surgery: higher educational levels (OR = 2.3; 95% CI, 1.2 to 4.4), duration of diabetes (OR = 0.4; 95% CI, 0.2 to 1.0) and use of insulin (OR = 2.1; 95% CI, 1.1 to 4.1). Reasons for surgery: desire for remission (Likert scale 4.7 ± 0.7), to prevent complications (Likert scale 4.5 ± 0.9) and to reduce medications (Likert scale 4.3 ± 1.1). For those not keen on surgery, main reasons were fear of surgery (Likert scale 4 ± 1.5) and satisfaction with current therapy (Likert scale 3.7 ± 1.6). Conclusion: Many diabetic patients would consider surgery as an option to improve their metabolic disorder (greater interest in patients with higher educational levels, currently using insulin and with shorter duration of diabetes). Surgical complications, length of recovery and duration of benefits were the main concerns. Key words: Metabolic surgery, Patient perception, Remission

The Attitude of type 2 Diabetic Patients Toward Intensive Weight Management and Bariatric Surgery

“…However, in contrast to others [25,42] in the present study, patients treated with metformin were more likely than others to agree that bariatric surgery will change their nutritional habits, change their life style and they will achieve their ideal weight one year after bariatric surgery while in other studies, patients treated with insulin were more interested to undergo bariatric surgery. This might be attributed to lower compliance of patients on oral therapy than those on insulin therapy.…”

“…In the present study and in accordance with others [25], more educated patients were more likely to have positive attitude towards effectiveness of bariatric surgery in management of their blood glucose, mostly because they are more understandable of the bariatric surgery and complications from diabetes mellitus.…”

“…in Singapore [25], minority of diabetic patients had heard about bariatric surgery in the management of diabetes. However, more than 60% of them were willing to undertake bariatric surgery after a short description of the benefits of it; particularly those with higher education, shorter duration of the disease and those treated with insulin.…”

“…an option to improve their metabolic disorder (greater interest in patients with higher educational levels, currently using insulin and with shorter duration of diabetes). Surgical complications, length of recovery and duration of benefits were the main concerns [25].…”

Type 2 diabetes remission after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one anastomosis gastric bypass (OAGB): results of the longitudinal assessment of bariatric surgery study

“…Given the invasive nature of bariatric surgery, it is critical to identify patients who can best benefit from surgery. Because by using the most metabolically effective procedure, some diabetic patients still did not reach diabetes remission after surgery [ 30 ]. The present study found that, younger patients, with a shorter duration of diabetes, and lower preoperative FBS and Hba1c, with higher preoperative BMI, that were less likely to, took insulin therapy and were less likely to have had a family history of obesity were more likely to have achieved T2DM remission 1-year and 3 years after bariatric surgery.…”