A Systematic Review and Meta-Analysis of Outcomes for Type 1 Diabetes after Bariatric Surgery

الملخص EN

Background.

The utility of bariatric surgery in type 1 diabetes remains controversial.

The aim of the present study is to evaluate glycemic control outcomes in obese patients with type 1 diabetes after bariatric surgery.

Methods.

A comprehensive search of electronic databases was completed.

Inclusion criteria included human adult subjects with BMI ≥35 kg/m2 and a confirmed diagnosis of type 1 diabetes who underwent a bariatric surgical procedure.

Results.

Thirteen primary studies (86 patients) were included.

Subjects had a mean age of 41.16 ± 6.76 years with a mean BMI of 42.50 ± 2.65 kg/m2.

There was a marked reduction in BMI postoperatively at 12 months and at study endpoint to 29.55 ± 1.76 kg/m2 ( P < 0.00001 ) and 30.63 ± 2.09 kg/m2 ( P < 0.00001 ), respectively.

Preoperative weighted mean total daily insulin requirement was 98 ± 26 IU/d, which decreased significantly to 36 ± 15 IU/d ( P < 0.00001 ) and 42 ± 11 IU/d ( P < 0.00001 ) at 12 months and at study endpoint, respectively.

An improvement in HbA1c was also seen from 8.46 ± 0.78 % preoperatively to 7.95 ± 0.55 % ( P = 0.01 ) and 8.13 ± 0.86 % ( P = 0.03 ) at 12 months and at study endpoint, respectively.

Conclusion.

Bariatric surgery in patients with type 1 diabetes leads to significant reductions in BMI and improvements in glycemic control.