Patients with coexisting type 1 diabetes and obesity are increasingly choosing to undergo bariatric surgery for weight management. Effectiveness and safety of bariatric surgery in this group is not established.
Retrospective, longitudinal review of clinical data of patients with type 1 diabetes, followed up at our Centre after bariatric surgery was performed elsewhere.
Sixty-one patients were included, 51% female, 57 (93%) Emirati Arab, 3 (5%) other Arab, 1 (2%) Caucasian, mean age at surgery 31 years. 42 (69%) underwent sleeve gastrectomy, 17 (28%) gastric bypass, 2 (3%) gastric band. In 48 patients with complete follow-up data, improvements were observed at 12 months in median (IQR) BMI (38.5 (34.9-40.9) to 26.1 (24.2-29.6) kg/m , p < 0.001), HbA1c (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) unit/kg/day, p < 0.001), systolic BP (127 (116-136) to 116 (110-120) mmHg, p < 0.001) and TC:HDL 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, median reduction in BMI was 10.4 (5.9-11.7) kg/m , 50% reduced or stopped antihypertensive and 58% reduced or stopped lipid-modifying medications. Three individuals each reported a single episode of diabetic ketoacidosis; in one case this was due to cessation of insulin treatment.
In these patients with obesity and type 1 diabetes, bariatric surgery led to significant improvements in weight and cardiometabolic parameters, with modest improvements in glycemia. Few adverse events were reported. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

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