Long-Term Outcomes in Patients with Morbid Obesity and Type 1 Diabetes Undergoing Bariatric Surgery

Vilarrasa, Núria; Rubio, Miguel A.; Miñambres, Inka; Flores, Lillian; Caixàs, Assumpta; Ciudin, Andrea; Bueno, Marta; García-Luna, Pedro Pablo; Ballesteros-Pomar, María D.; Ruiz-Adana, Marisol; Lecube, Albert

doi:10.1007/s11695-016-2390-y

Cited by 37 publications

(39 citation statements)

References 36 publications

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“…They concluded that bariatric surgery in patients with type 1 diabetes mellitus largely provides benefits of insulin requirements and some advantages related to the diabetes complication but have no effect on the glycemic control in the long term. (39) In another study, it was shown that longer duration of diabetes is associated with increasing age. They pointed that shorter duration of diabetes lead to patients with good metabolic response (1.75 ± 0.69 vs. 8.79 ± 2.8 years) and chance of complete remission after gastric bypass surgery was more in patients with a diabetes duration < 5 years.…”

Section: Discussionmentioning

confidence: 97%

Laparoscopic Roux-en-Y versus One Anastomosis Gastric Bypass on Remission of Diabetes in Morbid Obesity

Abed

Kabir

Jamshidi

et al. 2017

J Minim Invasive Surg Sci

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Background: Laparoscopic one anastomosis gastric bypass (OAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are common treatments for morbid obese patients who suffer from type 2 diabetes mellitus (T2DM). It has been hypothesized that diabetes may be resolved or improved after bariatric procedures, although the exact effect has not been well established. The present study aimed to compare remission of T2DM after LRYGB versus OAGB in this study. Methods: All diabetic obese patients, aged between 16 to 60, who referred to Hazrat Rasul Akram obesity clinic from April 2010 to March 2013 for LRYGB or OAGB were included in the present study. Pre-operative parameters, including glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), and type of diabetes medication were extracted from database and recorded. Pre-operative and three months postoperative values were then compared between the groups. Results: Out of 95 eligible patients, 50 patients underwent OAGB and 45 patients had LRYGB. The two groups were homogenous in distribution of gender, mean age, weight, BMI, and FPG; however, mean HbA1C was relatively higher in LRYGB group (P = 0.05) than other group, which was non-significant after adjustment. Rate of remission was significantly higher in OAGB group than other group after three months follow-up (64.0 versus 31.1%, respectively) (P = 0.002). Conclusions: In our short-term follow-up, OAGB had a higher rate of remission of T2DM compared to LRYGB, which could be due to different baseline value of HbA1c (before surgery) between two groups. Future research is thus suggested with linger follow-up and randomized study design.

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Section: Discussionmentioning

confidence: 97%

Laparoscopic Roux-en-Y versus One Anastomosis Gastric Bypass on Remission of Diabetes in Morbid Obesity

Abed

Kabir

Jamshidi

et al. 2017

J Minim Invasive Surg Sci

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show abstract

“…We believe that such patients may include some SPIDDM cases because it is difficult to distinguish SPIDDM from T2DM. Additionally, as in the present study, others have indicated the possibility of hypoglycemic attack after surgery . Patients with DM should be provided adequate education about nutrition after surgery, such as an appropriate diet and nutritional requirements, to prevent a hypoglycemic attack.…”

Section: Discussionmentioning

confidence: 53%

“…Although the subjects in this study achieved good weight loss and glycemic control of HbA1c and reduced their insulin requirements, there are some negative effects after surgery in T1DM patients. Some articles have shown that BS in patients with T1DM cannot achieve sufficient glycemic control of HbA1c . As such, we have to monitor our subjects strictly because their glycemic control will probably get worse.…”

Section: Discussionmentioning

confidence: 99%

Mid‐term results of bariatric surgery in morbidly obese Japanese patients with slow progressive autoimmune diabetes

Uno

Seki

Kasama

et al. 2017

Asian J Endoscop Surgery

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Bariatric surgery for morbidly obese patients with anti-glutamic acid decarboxylase antibody-positive type 1 diabetes mellitus, especially slow progressive autoimmune diabetes, seemed effective in achieving mid-term glycemic control. Longer follow-up with a larger number of patients, as well as validation with more advanced patients with slowly progressive insulin-dependent diabetes mellitus, will be needed.

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“…Surgery was associated with a significant reduction in bodyweight, insulin requirements, improvement of obesity comorbidities and some diabetes complications. 102 However, there was only a marginal effect on glycaemic control in treated patients on long-term follow-up.…”

Section: Bariatric Surgery For Type 1 Diabetes Mellitusmentioning

confidence: 98%

Non-pharmacological Treatment Options in the Management of Diabetes Mellitus

Raveendran

Chacko

Pappachan

2018

European Endocrinology

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The global prevalence of diabetes, especially type 2 diabetes mellitus, has reached epidemic proportions in the last few decades of the 20th century because of the obesity pandemic resulting from adverse lifestyles. Diabetes as a consequence of obesity (diabesity), continues to increase exponentially in the 21st century. Although there are a multitude of drugs for the effective management of diabesity with modest benefits, most patients will require insulin for control of diabetes at some stage that would worsen obesity, and thereby diabesity. Therefore, effective non-pharmacological therapy needs to be expedited in all patients with diabesity. These measures include medical nutrition interventions, change of lifestyles and bariatric surgery. Non-pharmacological interventions are also useful for the effective management of even type 1 diabetes mellitus when used along with insulin therapy especially in those with obesity. This review summarises the current evidence base for the non-pharmacological interventions in the management of diabetes.

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Long-Term Outcomes in Patients with Morbid Obesity and Type 1 Diabetes Undergoing Bariatric Surgery

Cited by 37 publications

References 36 publications

Laparoscopic Roux-en-Y versus One Anastomosis Gastric Bypass on Remission of Diabetes in Morbid Obesity

Laparoscopic Roux-en-Y versus One Anastomosis Gastric Bypass on Remission of Diabetes in Morbid Obesity

Mid‐term results of bariatric surgery in morbidly obese Japanese patients with slow progressive autoimmune diabetes

Non-pharmacological Treatment Options in the Management of Diabetes Mellitus

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