P200 - LONG-TERM WEIGHT AND HBA1C % CHANGES FOLLOWING METABOLIC BARIATRIC SURGERY: A COMPARATIVE ANALYSIS USING ROUTINE CLINICAL DATA IN SCOTLAND

P200

LONG-TERM WEIGHT AND HBA1C % CHANGES FOLLOWING METABOLIC BARIATRIC SURGERY: A COMPARATIVE ANALYSIS USING ROUTINE CLINICAL DATA IN SCOTLAND

B. Leyaro^1,*, R. Carragher¹, A. Ali ²

¹School of Computing, Engineering and Physical Sciences, University of the West of Scotland, Paisley, ²epartment of General & Upper GI Surgery, University Hospital Ayr, Ayr, Scotland, UK, Ayr, United Kingdom

Rationale: Bariatric surgery is a key intervention for individuals with severe obesity, providing substantial and sustained weight loss and improvement in comorbidities.  However, limited research has examined long-term weight and glycemic changes by comparing outcomes between patients who undergo surgery and those who do not, despite being eligible after referral.

Methods: This retrospective cohort study included adults with type 2 diabetes and obesity referred for metabolic bariatric surgery (MBS) at University Hospital Ayr, Ayrshire & Arran, between 2009 and 2020. The primary outcomes were percentage total weight loss (%TWL) and change in hemoglobin A1c (HbA1c%) from baseline to five years.

Results: A total of 411 patients were included, 225 (54.7%) did not undergo bariatric surgery. The mean (SD) age was 48.3 (8.5) years, with no significant baseline body mass index difference between the surgery and non-surgery groups [mean (SD) 47.4 (7.9) kg/m²]; 63.3% were women. At five years, patients who underwent surgery maintained a 22.0% weight reduction compared to 8.6% in the non-surgery group (P < 0.001). HbA1c% decreased by 1.0% (95% CI, −1.31 to -0.70) in the surgery group but increased by 0.4% (95% CI, 0.09 to 0.71) in the non-surgery group.  Adjusted mixed models showed that, surgery group had a -0.13% (95% CI, -0.18 to -0.07; P < 0.001) change in HbA1c% and a -1.31% (95% CI, -1.73 to -0.88; P < 0.001)  %TWL compared to the non-surgery group.

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Conclusion: Patients who undergo bariatric surgery achieve superior weight loss and glycemic control compared to non-surgical patients. Opting out of surgery may have significant health implications, highlighting the need for alternative interventions such as intensive lifestyle modification, pharmacotherapy, and diabetes education programs for those unable or unwilling to undergo MBS.

Disclosure of Interest: None declared