Bariatric surgery may benefit obese patients with type 1 diabetes (T1D), by leading not only to significant weight loss, but improvements in insulin requirements and glycemic status, according to a study recently published in Diabetes Care.
Researchers led by John P. Kirwan, PhD, and Ali Aminian, MD, both of the Cleveland Clinic, point out that although approximately 50% of patients with T1D are obese or overweight and between 20 and 40% have metabolic syndrome, there “is paucity of data on the impact of bariatric surgery in patients with T1D.” They searched a variety of databases from the time those databases were started until December 2015 and reviewed 17 studies with 107 patients to “quantify the overall effects of bariatric surgery in obese patients with T1D.”
About 65% of these patients had gastric bypass, and they write that all studies reported a significant reduction in excess weight and a significant reduction in daily insulin requirements (except for one study). Common postoperative complications were also reported, as well as some more serious complications such as diabetic ketoacidosis.
The authors conclude: “The favorable metabolic effects of bariatric surgery may facilitate medical management of and cardiovascular risk reduction in T1D in the setting of severe obesity. Diabetic ketoacidosis and hypoglycemia are potentially serious complications. Short-term results of bariatric surgery in patients with T1D are encouraging, but larger and longer-term studies are needed.”