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Obesity Surgery

, Volume 27, Issue 4, pp 856–863 | Cite as

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

  • Nuria VilarrasaEmail author
  • Miguel Angel RubioEmail author
  • Inka Miñambres
  • Lillian Flores
  • Assumpta Caixàs
  • Andrea Ciudin
  • Marta Bueno
  • Pedro Pablo García-Luna
  • María D. Ballesteros-Pomar
  • Marisol Ruiz-Adana
  • Albert Lecube
Original Paper

Abstract

Background

This study aims to describe the long-term outcomes of bariatric surgery in a cohort of patients with type 1 diabetes (T1DM).

Methods

Thirty-two patients with T1DM and initial BMI of 41.3 ± 4.8 kg/m2 were studied, 18.7 % undergoing duodenal switch (DS), 34.4 % gastric bypass, and 46.9 % sleeve gastrectomy and followed-up after surgery for 4.6 ± 2.6 years. Changes in BMI, HbA1c, insulin requirements, evolution of comorbidities, and microvascular complications were registered annually after surgery.

Results

Percentage of total weight loss (%TWL) 12 months after surgery was 30.4 ± 9.2 % and at 5 years, it decreased to 28.1 ± 11.5 % (p = 0.02). HbA1c was reduced during the first year from 8.5 ± 1.3 to 7.9 ± 1.4 %, p = 0.016. In the long-term, HbA1c returned to baseline values. There was a sustained reduction of 51 % in total daily insulin dose, and the decrease in the number of patients with hypertension, dyslipidemia, and obstructive sleep apnea was 42.8, 25, and 66 %, respectively. Retinopathy remained mainly unaffected, and 25 % of patients with microalbuminuria regressed to normoalbuminuria.

Conclusions

Bariatric surgery in patients with T1DM mainly provides benefits of weight reduction, on insulin requirements, obesity comorbidities, and some benefits in diabetes complications, but might have only minimal effect on the glycemic control in the long term.

This trial was registered at www.controlledtrials.com as ISRCTN49980913.

Keywords

Type 1 diabetes Bariatric surgery Morbid obesity Metabolic control Microvascular complications 

Notes

Acknowledgments

We would like to thank The Obesity Group of the Spanish Society of Endocrinology and Nutrition (GOSEEN) for participating and providing data for this study. The authors thank Dr. Jonathan Rogerson for his valuable help with the English version of the manuscript.

Compliance with Ethical Standards

Funding

This study was funded by grant “Ajuts per a projectes de recerca clínica de l’Hospital Universitari de Bellvitge (2011-PR143/11).”

Conflict of Interest

The authors declare that they have no conflict of interest.

Grant Support

Dr. Vilarrasa is currently receiving a grant “Ajuts per a projectes de recerca clínica de l’Hospital Universitari de Bellvitge (2011-PR143/11).”

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Nuria Vilarrasa
    • 1
    • 2
    Email author
  • Miguel Angel Rubio
    • 3
    Email author
  • Inka Miñambres
    • 4
  • Lillian Flores
    • 2
    • 5
  • Assumpta Caixàs
    • 6
  • Andrea Ciudin
    • 7
  • Marta Bueno
    • 8
  • Pedro Pablo García-Luna
    • 9
  • María D. Ballesteros-Pomar
    • 10
  • Marisol Ruiz-Adana
    • 11
  • Albert Lecube
    • 8
  1. 1.Department of Endocrinology and NutritionHospital Universitario de Bellvitge-IDIBELL, L’Hospitalet de LlobregatBarcelonaSpain
  2. 2.CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas AsociadasInstituto de Salud Carlos IIIMadridSpain
  3. 3.Department of Endocrinology and NutritionHospital Clínico San Carlos, IDISSCMadridSpain
  4. 4.Endocrinology and Nutrition DepartmentHospital de La Santa Creu i Sant PauBarcelonaSpain
  5. 5.Department of Endocrinology and Nutrition, Obesity UnitHospital Clínic UniversitariBarcelonaSpain
  6. 6.Endocrinology and Nutrition Department, Corporació Sanitària Parc Taulí, Institut de Recerca I3PTSabadell University Hospital (UAB)SabadellSpain
  7. 7.Endocrinology and Nutrition Department, Morbid Obesity UnitHospital Vall d’HebronBarcelonaSpain
  8. 8.Endocrinology and Nutrition DepartmentHospital Universitari Arnau de VilanovaLleidaSpain
  9. 9.U. Nutricion. U.G. Endocrinologia y NutricionHospital Universitario Virgen del RocíoSevillaSpain
  10. 10.Endocrinology and Nutrition DepartmentComplejo Asistencial Universitario de LeónLeónSpain
  11. 11.Endocrinology and Nutrition DepartmentHospital Regional Universitario Carlos HayaMálagaSpain

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