Unraveling the risk factors for type II diabetes in severe obese patients with indication for bariatric surgery: retrospective analysis

Background and Aims Type II Diabetes Mellitus (T2DM) is a frequent comorbidity among severely obese individuals undergoing bariatric surgery evaluation. This study aimed to investigate clinical and demographic associated factors of T2DM to support improved preoperative risk stratification and guide preventive strategies. Methods and Results We performed a retrospective analysis of 734 patients assessed for bariatric surgery. Associations between T2DM and age, gender, hypertension, dyslipidemia, smoking status, and body mass index (BMI) were evaluated using logistic regression and Fisher's exact tests. The cohort had a mean age of 39 years (SD = 11.5) and mean BMI of 41.92 kg/m 2 (SD = 5.16). T2DM prevalence was 9.5%. Hypertension (p = 0.0098; OR=2.344), dyslipidemia (p = 0.0009; OR=2.467), and smoking (p = 0.00097; OR=2.367) were significantly associated with T2DM, whereas gender showed no association (p = 0.4818). Multivariate logistic regression refined by Akaike Information Criterion identified age (OR = 1.0245), hypertension (OR = 1.9083), dyslipidemia (OR = 2.0851), and smoking (OR = 2.259) as independent predictors. The model showed excellent sensitivity (0.98) and high negative predictive value (0.987) but low specificity (0.116), supporting its utility for ruling out T2DM among low-risk individuals. Conclusion T2DM in severe obesity is driven by multiple factors, including age, hypertension, dyslipidemia, and smoking. These findings highlight modifiable risk factors that may serve as targets for early intervention. Incorporating comprehensive risk stratification into preoperative assessment may improve clinical decision-making and preventive strategies in high-risk obese populations.