Evidence mapPaperPMID 41566288Full record

ArticleBMC surgery2026

Bitter-sweet? The role of glycemic control in breast reduction surgery.

Samuel Knoedler, Thomas Schaschinger, Felix J Klimitz, Victoria Kong, Julius M Wirtz, Omar Allam, Fabio O Marcela, Jun Jiang, Gabriel Hundeshagen, Adriana C Panayi and 2 more

Abstract read
In one paragraph

Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Samuel Knoedler *Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany. samuel.knoedler@tum.de.
Thomas Schaschinger *Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
Felix J KlimitzDepartment of Surgery, Division of Plastic and Reconstructive Surgery, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA.
Victoria KongDepartment of Surgery, Division of Plastic and Reconstructive Surgery, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA.
Julius M WirtzFaculty of Medicine, University of Freiburg, Freiburg, Germany.
Omar AllamDepartment of Surgery, Division of Plastic and Reconstructive Surgery, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA.
Fabio O MarcelaDepartment of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Jun JiangDepartment of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Gabriel HundeshagenDepartment of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
Adriana C PanayiDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Fortunay DiattaDepartment of Surgery, Division of Plastic and Reconstructive Surgery, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA.
Martin Kauke-NavarroDepartment of Surgery, Division of Plastic and Reconstructive Surgery, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA. kauke-navarro.martin@yale.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe American Society of Plastic Surgeons guidelines emphasize the need for additional evidence regarding perioperative glycemic control in patients with diabetes undergoing breast reduction surgery. This study evaluates the association between preoperative hemoglobin A1c (HbA1c) levels and postoperative complications in patients with diabetes undergoing reduction mammaplasty.

methodsA retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database was performed, identifying patients diagnosed with diabetes who underwent breast reduction surgery from 2021 to 2023. Patients were stratified by preoperative HbA1c levels: well-controlled (HbA1c < 6.5%) versus poorly controlled (HbA1c ≥ 6.5%). Demographics, surgical characteristics, and 30-day postoperative outcomes were compared between groups. Multivariable logistic regression analysis was performed to identify independent risk factors for complications.

resultsA total of 364 female patients with diabetes met the inclusion criteria, of whom 293 (80%) had non–insulin-dependent and 71 (20%) had insulin-dependent diabetes. Based on HbA1c levels, 206 patients (57%) had well-controlled diabetes, and 158 (43%) had poorly controlled diabetes. The groups were comparable in age, BMI, and surgical characteristics. The overall complication rate was 10.7% (n = 39), with superficial surgical site infections being the most common (n = 22, 6.0%). Patients with poorly controlled diabetes had higher rates complications overall (13.0% vs. 9.2%, p = 0.29) and readmission (4.4% vs. 1.0%, p = 0.044). In multivariable analysis, HbA1c ≥ 6.5% was independently associated with an increased risk of complications (OR 2.2, 95% CI 1.0–4.7, p = 0.047).

conclusionPatients with diabetes and poorly controlled glycemic status demonstrate a higher likelihood of postoperative complications following breast reduction surgery, although the association reached only borderline statistical significance. These findings support the clinical plausibility that suboptimal glycemic control may contribute to increased perioperative risk and may help inform patient counseling and surgical decision-making in this population. Further research is needed to clarify the extent to which preoperative glycemic optimization influences outcomes in this population.

Indexed as

Diabetes MellitusGlycated HemoglobinGlycemic ControlMammaplastyPostoperative ComplicationsAdultFemaleHumansMiddle AgedRetrospective StudiesRisk FactorsGlycated Hemoglobinhemoglobin A1c protein, humanBreast reductionDiabetesDiabetes mellitusInsulinNSQIPReduction mammoplasty

Identifiers

PMID41566288
PMCPMC12849521

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.