Obesity and poor glycemic control are increasingly prevalent among surgical patients and are independently associated with adverse postoperative outcomes. However, their combined impact and potential synergistic effects remain incompletely understood. To critically evaluate the relationship between body mass index (BMI), glycated hemoglobin (HbA1c), and postoperative complications, with emphasis on their interaction and clinical implications. Narrative review based on analysis of key observational studies, meta-analyses, and clinical trials addressing obesity, glycemic control, and surgical outcomes. Elevated BMI and HbA1c are consistently associated with increased risk of postoperative complications, particularly infectious events and impaired wound healing. Their coexistence appears to amplify surgical risk beyond isolated effects. The combined assessment of BMI and HbA1c represents a clinically relevant strategy for perioperative risk stratification and may guide optimization of surgical patients.
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