Knowledge and acceptance towards metabolic surgery as part of diabetes management among patients with type-2 diabetes with body mass index ? 30 Kg/m2 in ministry of health primary health care centers, Jeddah, 2017

Introduction: Metabolic surgery is a treatment option for the Type-2 Diabetes (T2D) patients with high BMI. Are T2D patients aware or willing to undergo metabolic surgery needs to be answered. Objectives: The objectives of the study were assessment of the level of knowledge of effectiveness of metabolic surgery in T2D treatment, remission and its acceptance as part of diabetes management; AND finding the determinants of the knowledge and acceptance of this procedure among T2D patients with BMI ? 30 kg/m2 in Primary heath care centers (PHCCs) of Jeddah, Saudi Arabia. Materials and Methods: A cross-sectional study, with a total of 455 interviews, was conducted using standard Likert-type questionnaire, among T2D patients with BMI ? 30 kg/m2, who attended five randomly selected PHCC's in Jeddah. Binary logistic regression analysis was done to identify the determinants of knowledge and acceptance of metabolic surgery. Results: The majority were Saudi citizens (83.7%) and females (55.6%). The mean age was 47.6 ± 9.6 years (23-65 years) and the mean BMI was 34.3 ± 3.3 kg/m2 (30-45.8 kg/m2. About 41.1% had no clear opinion for the question on effectiveness of metabolic surgery. Among the remaining (268), 63.1% felt it is effective in T2D treatment and 60.6% in T2D Remission. Out of 348 patients, 49.1% were willing for metabolic surgery and 40.3% not willing. The adjusted determinants of willing to undergo metabolic surgery were age, (54 years plus vs 36 years or less: OR=0.230; 95% CI=0.069-0.769); education (bachelor degree vs illiterates: OR=0.025; 95%CI=0.001-0.890); 5000-15000 SR/month vs less than 5000 SR/month: OR=6.910; 95% CI=2.890-16.519); marital status (widower vs singles: OR=0.027;95%CI= 0.003-0.219); and A1c level (A1c level 10 or more vs A1c level ? 5 - <10 R=3.274; CI=1.736-6.174).> Conclusion: The good knowledge of metabolic surgery among participants did not enhance to willingness to accept it as T2D management. Age, marital status, education level, income and A1c level determine the willingness for metabolic surgery among T2D patients with BMI >30 or more.