A retrospective review of the medical management of hypertension and diabetes mellitus following sleeve gastrectomy

Obes Surg. 2015 Apr;25(4):642-7. doi: 10.1007/s11695-014-1375-y.


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.

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / surgery
  • Female
  • Gastrectomy*
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / surgery
  • Insulin / therapeutic use*
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / drug therapy*
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Postoperative Period
  • Retrospective Studies
  • Weight Loss


  • Antihypertensive Agents
  • Insulin