title: Bariatric Surgery in Obese Patients with Type 1 Diabetes: Effects on Weight Loss and Metabolic Control.
abstract: Type 1 diabetes patients, although typically lean, experience an increased prevalence of obesity, and bariatric surgery is considered in severe cases. Bariatric surgery in such patients leads to significant weight loss and decreased insulin requirements; however, effects on glycemic control remain discussed. We assessed, in obese patients with type 1 diabetes, the effects of bariatric surgery upon body weight, body composition, and glycemic control, including the occurrence of hypoglycemic events.
  
  
  
  Thirteen obese patients with type 1 diabetes who underwent bariatric surgery (Roux-en-Y gastric bypass n = 6, sleeve gastrectomy n = 7) were matched with obese patients without diabetes and with type 2 diabetes patients during 12 months of follow-up. Outcomes included body weight, DXA-assessed body composition, HbA1c, and incidence of hypoglycemia.
  
  
  
  At 12 months, median surgery-induced weight loss was 27.9 % (21.1-33.3), 26.1 % (24.8-29.7), and 27.5 % (21.8-32.1) in patients with type 1 diabetes, type 2 diabetes, and without diabetes, respectively, with no significant differences across the groups. Similar findings were observed for body fat changes. At 12 months, median HbA1c decreased from 8.3 to 7.6 % in type 1 diabetes patients versus 8.0 to 5.9 % in type 2 diabetes patients (P = 0.04 between the groups). In type 1 diabetes patients, the number of reported minor hypoglycemia increased transiently only at 6 months. Two patients reported severe hypoglycemia (one episode each).
  
  
  
  Type 1 diabetes patients benefit from bariatric surgery in terms of weight loss and glycemic control. Close monitoring of insulin therapy appears warranted to prevent minor hypoglycemia in the first months post-surgery.
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Pierre-et-Marie-Curie University-Paris 6 (UPMC), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Faucher
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Pierre-et-Marie-Curie University-Paris 6 (UPMC), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.|INSERM, U872, Team 7 Nutriomique, Cordeliers Research Center, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Poitou
authors.affiliation: Department of Nutrition, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Versailles Saint-Quentin University, Boulogne-Billancourt, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Carette
authors.affiliation: Department of Biostatistics, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Pierre-et-Marie-Curie University-Paris6 (UPMC), Paris, France.|INSERM U 1136, UMR S 1136, Sorbonne Universités, Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Tezenas du Montcel
authors.affiliation: Department of Nutrition, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Versailles Saint-Quentin University, Boulogne-Billancourt, Paris, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Barsamian
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Pierre-et-Marie-Curie University-Paris 6 (UPMC), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
authors.forename: Eliabelle
authors.initials: E
authors.lastname: Touati
authors.affiliation: Department of General, Digestive, and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, Paris, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bouillot
authors.affiliation: Department of Digestive and Hepato-Pancreato-Biliary Surgery, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, University Institute of Cancerology, Pierre-et-Marie- Curie University-Paris 6 (UPMC), Paris, France.
authors.forename: Adriana
authors.initials: A
authors.lastname: Torcivia
authors.affiliation: Department of Nutrition, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Versailles Saint-Quentin University, Boulogne-Billancourt, Paris, France.|INSERM UMS 011-Cohortes en population, Villejuif, Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Czernichow
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Pierre-et-Marie-Curie University-Paris 6 (UPMC), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France. jean-michel.oppert@aphp.fr.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Pierre-et-Marie-Curie University-Paris 6 (UPMC), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Ciangura
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism*; D001823:Body Composition; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000601:surgery; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Body composition; Hypoglycemia; Metabolic control; Obesity; Type 1 diabetes