title: A Systematic Review and Meta-Analysis of Outcomes for Type 1 Diabetes after Bariatric Surgery.
abstract: 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/m(2) 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/m(2). There was a marked reduction in BMI postoperatively at 12 months and at study endpoint to 29.55 ± 1.76 kg/m(2) (P < 0.00001) and 30.63 ± 2.09 kg/m(2) (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.
authors.affiliation: Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada T6G 2R7.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Chow
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7.
authors.forename: Noah J
authors.initials: NJ
authors.lastname: Switzer
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7.
authors.forename: Jerry
authors.initials: J
authors.lastname: Dang
authors.affiliation: Center for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, AB, Canada T5H 3V9.
authors.forename: Xinzhe
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7; Center for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, AB, Canada T5H 3V9.
authors.forename: Christopher
authors.initials: C
authors.lastname: de Gara
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7; Center for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, AB, Canada T5H 3V9.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Birch
authors.affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Richdeep S
authors.initials: RS
authors.lastname: Gill
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7; Center for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, AB, Canada T5H 3V9.
authors.forename: Shahzeer
authors.initials: S
authors.lastname: Karmali
mesh_terms: D050110:Bariatric Surgery; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome