A Retrospective Review of the Medical Management of Hypertension and Diabetes Mellitus Following Sleeve Gastrectomy

Background: Bariatric surgery is being performed with increasing frequency in the USA as a definitive treatment for morbid obesity and associated comorbidities. Management strategies of type 2 diabetes mellitus (T2DM) and hypertension (HTN) medications in sleeve gastrectomy (SG) patients postoperatively are unclear, specifically in the immediate postoperative period and 6 months following surgery. Methods: From 01 June 2010 to 30 June 2011, at a single military medical facility, a retrospective review of 88 consecutive SG patients was conducted to examine the postoperative medical management of HTN and T2DM. Patient’s HTN and T2DM medication regimens were evaluated for 6 months postoperatively. Categorical data was analyzed using chi-square, and continuous data was compared using the Student t test. Statistical analyses were completed with Stata, version 12. Results: Fifty patients were prescribed an average of 2.21 HTN medications at baseline which was reduced to an average of 1.23 (p < 0.01) medications per patient at 1 month. Twenty-four patients received an average of 1.41 oral T2DM medications with a reduction to 0.70 (p < 0.01) on average at 1 month postoperatively. Medication changes persisted throughout the 6-month follow-up. Among T2DM patients requiring insulin therapy, the mean insulin dose was 42.1 units reduced to 16.8 units immediately postoperatively (p < 0.01) which persisted at 1 month. At 6 months, the mean insulin dose was 13.3 units. Conclusions: Medication adjustments for HTN and T2DM made immediately in the postoperative period following SG persisted throughout the 6-month follow-up period and in some patients, required further adjustments.