Laparoscopic Sleeve Gastrectomy for the Management of Type 1 Diabetes Mellitus
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The prevalence of obesity is on a continuous rise worldwide, with major studies clearly correlating obesity with the development of chronic metabolic disorders including type 2 diabetes. Bariatric surgery has proven to be beneficial in the management of this condition; however, a limited number of studies exist on its effect on type 1 diabetes.
The objective of this study is to evaluate the outcome of laparoscopic sleeve gastrectomy for the management of patients with type 1 diabetes (DM1).
This is a retrospective cohort study conducted in a university hospital and private practice in Kuwait.
Research Design and Methods
Analysis was conducted on 10 patients diagnosed with type 1 diabetes that underwent bariatric surgery from October 2008 until December 2016 at Amiri Hospital and Royale Hayat Hospital, Kuwait. Primary parameters included body mass index (BMI), % excess weight (%EWL) loss at follow-up, glycosylated hemoglobin (A1C), and basal insulin requirements. Total cholesterol readings and fasting blood glucose (FBS) levels were considered secondary outcomes. Statistical analysis of the data was carried out using Statistical Package for the Social Sciences (SPSS) software.
Mean BMI showed a reduction from 41.9 ± 5.4 to 31.4 ± 8.4 kg/m2. Mean %EWL after the follow-up period was 74.4 ± 25.3%. A1C levels failed to show a significant difference 12 months post-op (p = 0.189). Cholesterol levels did not display a significant decrease either (p = 0.447). When it came to insulin requirements, a significant difference was perceived, with the mean number of units of insulin required dropping from 76.6 to 18.2 (p = 0.026). FBS readings also showed a drop from 15.1 ± 3.8 to 7.8 ± 2.9 mmol/L (p = 0.001).
Laparoscopic sleeve gastrectomy resulted in significant weight loss, comorbidity resolution as well as reduction in their insulin doses post-op. However, glycemic control does not seem to show significant improvement in these patients. Larger, more long-term studies are needed to reach a definite conclusion on this topic.
KeywordsObesity Diabetes Type 1 Sleeve gastrectomy Kuwait
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study. Additional informed consent does not apply.
- 1.State of Victoria (1999) Victorian Burden of Disease Study: Morbidity Public Health Division, Department of Human Services Melbourne Victoria, Australia.Google Scholar
- 8.The American Society for Metabolic and Bariatric Surgery.Google Scholar
- 9.NDEI.org. Guidelines for Hypoglycemia in Diabetes ADA/Endocrine Society. N.p., n.d. Web. 04 July 2016.
- 22.Dirksen C, Jacobsen SH, Bojsen-Møller KN, et al. Reduction in cardiovascular risk factors and insulin dose, but no beta-cell regeneration 1 year after Roux-en-Y gastric bypass in an obese patient with type 1 diabetes: a case report. Obes Res Clin Pract. 2013;7(4):e269–74.CrossRefPubMedGoogle Scholar
- 26.Robert M, Belanger P, Hould FS, et al. Shouldmetabolic surgery be offered in morbidly obese patients with type I diabetes? Surg Obes Relat Dis. 2014; doi: 10.1016/j.soard.2014.12.016.