title: Bariatric surgery and diabetes: Implications of type 1 versus insulin-requiring type 2.
abstract: OBJECTIVE
  To report the impact of bariatric surgery on metabolic outcomes in patients with type 1 diabetes (DM1) versus insulin-requiring type 2 diabetes mellitus (IRDM2).
  
  
  METHODS
  Ten subjects with DM1 were compared with 118 subjects with IRDM2 at baseline and at 1 and 2 years post-bariatric surgery for: anthropometric measures, HbA1c, and number of medications (anti-hyperglycemic, anti-hypertensive, lipid-lowering).
  
  
  RESULTS
  DM1 and IRDM2 groups lost similar amounts of weight 2 years post-bariatric surgery (39.5 ± 14.7 kg vs. 40.3 ± 24.4 kg). IRDM2 subjects had significant improvements in HbA1c (7.8% ± 1.4% vs. 6.8% ± 1.4%, P value <0.0001) and decreases in number of anti-hyperglycemic (2.4 ± 0.8 vs. 0.7 ± 0.8, P value <0.0001), anti-hypertensive (2.2 ± 1.3 vs. 1.3 ± 1.2, P value <0.0001), and lipid-lowering (1.1 ± 0.8 vs. 0.6 ± 0.6, P value <0.0001) medications. DM1 subjects had no improvement in HbA1c (8.2% ± 1.6% vs. 7.8% ± 0.9%) or use of anti-hypertensive medications (2.1 ± 1.4 vs. 2.3 ± 1.5). Their use of lipid-lowering medications improved (1.0 ± 0.5 vs. 0.5 ± 0.8, P value 0.04).
  
  
  CONCLUSIONS
  Our study suggests that improved glycemic control may not be an expected outcome when considering bariatric surgery in patients with DM1; however, additional investigation is warranted.
authors.affiliation: Division of Endocrinology, Diabetes, Metabolism, and Nutrition and Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Spyridoula
authors.initials: S
authors.lastname: Maraka
authors.forename: Yogish C
authors.initials: YC
authors.lastname: Kudva
authors.forename: Todd A
authors.initials: TA
authors.lastname: Kellogg
authors.forename: Maria L
authors.initials: ML
authors.lastname: Collazo-Clavell
authors.forename: Manpreet S
authors.initials: MS
authors.lastname: Mundi
mesh_terms: D000886:Anthropometry; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin