Bariatric surgery in the treatment of patients with obesity and type 1 diabetes: A retrospective study of clinical data.

Autor: Mohammed N; Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates., Buckley A; Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates., Elsheikh M; Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates., Allum M; Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates., Suliman S; Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates., Al Hadad M; Bariatric and Metabolic Surgery Centre, Healthpoint, Abu Dhabi, United Arab Emirates., le Roux CW; Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.; Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland., Lessan N; Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates., Suliman M; Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2021 Jul; Vol. 23 (7), pp. 1562-1570. Date of Electronic Publication: 2021 Mar 29.
DOI: 10.1111/dom.14369
Abstrakt: Aim: To evaluate the effectiveness and safety of bariatric surgery in patients with coexisting type 1 diabetes and obesity who choose to undergo bariatric surgery for weight management.
Materials and Methods: We conducted a retrospective, longitudinal review of the clinical data of patients with type 1 diabetes, followed up at our centre after bariatric surgery had been performed elsewhere.
Results: Sixty-one patients were included, of whom 51% were women, and 57 (93%) were Emirati Arab, three (5%) were other Arab, and one (2%) was White in ethnic origin. The mean age at surgery was 31 years. A total of 42 patients (69%) underwent sleeve gastrectomy, 17 (28%) gastric bypass, and two (3%) gastric banding. In 48 patients with complete follow-up data, improvements were observed at 12 months in the median (interquartile range [IQR]) values for body mass index (BMI; 38.5 [34.9-40.9] to 26.1 [24.2-29.6] kg/m 2 , P <0.001), glycated haemoglobin concentration (8.6 [7.8-9.2]% to 7.8 [7.2-8.5]%; P <0.001), daily insulin dose (1.0 [0.7-1.2] to 0.8 [0.6-0.9] units/kg/d; P <0.001), systolic blood pressure (127 [116-136] to 116 [110-120] mmHg; P <0.001), total cholesterol: high-density lipoprotein cholesterol ratio (3.4 [2.9-4.3] to 3.0 [2.6-3.5]; P <0.001), and albuminuria. In 32 patients followed up at 3 years, the median (IQR) reduction in BMI was 10.4 (5.9-11.7) kg/m 2 , 50% reduced or stopped antihypertensive medication and 58% reduced or stopped lipid-modifying medication. Three patients each reported a single episode of diabetic ketoacidosis; in one case this was due to cessation of insulin treatment.
Conclusions: In our cohort of patients with obesity and type 1 diabetes, bariatric surgery led to significant improvements in weight and cardiometabolic variables, with modest improvements in glycaemia. Few adverse events were reported.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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