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Laparoscopic Sleeve Gastrectomy for the Management of Type 1 Diabetes Mellitus

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Abstract

Background

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.

Objective

The objective of this study is to evaluate the outcome of laparoscopic sleeve gastrectomy for the management of patients with type 1 diabetes (DM1).

Setting

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.

Results

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).

Conclusions

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.

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Authors and Affiliations

  1. Al Amiri Hospital, Kuwait City, Kuwait

    Salman Al Sabah, Eliana Al Haddad, Talal H. Muzaffar & Ahmad Almulla

Authors
  1. Salman Al Sabah
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  2. Eliana Al Haddad
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  3. Talal H. Muzaffar
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  4. Ahmad Almulla
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Corresponding author

Correspondence to Salman Al Sabah.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

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

Informed consent was obtained from all individual participants included in the study. Additional informed consent does not apply.

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Al Sabah, S., Al Haddad, E., Muzaffar, T.H. et al. Laparoscopic Sleeve Gastrectomy for the Management of Type 1 Diabetes Mellitus. OBES SURG 27, 3187–3193 (2017). https://doi.org/10.1007/s11695-017-2777-4

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  • DOI: https://doi.org/10.1007/s11695-017-2777-4

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