title: Long-Term Outcomes in Patients with Morbid Obesity and Type 1 Diabetes Undergoing Bariatric Surgery.
abstract: This study aims to describe the long-term outcomes of bariatric surgery in a cohort of patients with type 1 diabetes (T1DM).
  
  
  
  Thirty-two patients with T1DM and initial BMI of 41.3 ± 4.8 kg/m2were studied, 18.7 % undergoing duodenal switch (DS), 34.4 % gastric bypass, and 46.9 % sleeve gastrectomy and followed-up after surgery for 4.6 ± 2.6 years. Changes in BMI, HbA1c, insulin requirements, evolution of comorbidities, and microvascular complications were registered annually after surgery.
  
  
  
  Percentage of total weight loss (%TWL) 12 months after surgery was 30.4 ± 9.2 % and at 5 years, it decreased to 28.1 ± 11.5 % (p = 0.02). HbA1cwas reduced during the first year from 8.5 ± 1.3 to 7.9 ± 1.4 %, p = 0.016. In the long-term, HbA1creturned to baseline values. There was a sustained reduction of 51 % in total daily insulin dose, and the decrease in the number of patients with hypertension, dyslipidemia, and obstructive sleep apnea was 42.8, 25, and 66 %, respectively. Retinopathy remained mainly unaffected, and 25 % of patients with microalbuminuria regressed to normoalbuminuria.
  
  
  
  Bariatric surgery in patients with T1DM mainly provides benefits of weight reduction, on insulin requirements, obesity comorbidities, and some benefits in diabetes complications, but might have only minimal effect on the glycemic control in the long term. This trial was registered at www.controlledtrials.com as ISRCTN49980913.
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, c/ Feixa Llarga s/n, 08907, Barcelona, Spain. nuriavilarrasa@yahoo.es.|CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain. nuriavilarrasa@yahoo.es.
authors.forename: Nuria
authors.identifier: 0000-0003-3188-1990
authors.initials: N
authors.lastname: Vilarrasa
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IDISSC, Martín Lagos s/n, 28040, Madrid, Spain. marubioh@gmail.com.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Rubio
authors.affiliation: Endocrinology and Nutrition Department, Hospital de La Santa Creu i Sant Pau, C/Sant Antoni Maria Claret 167, 08025, Barcelona, Spain.
authors.forename: Inka
authors.initials: I
authors.lastname: Miñambres
authors.affiliation: CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain.|Department of Endocrinology and Nutrition, Obesity Unit, Hospital Clínic Universitari, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: Lillian
authors.initials: L
authors.lastname: Flores
authors.affiliation: Endocrinology and Nutrition Department, Corporació Sanitària Parc Taulí, Institut de Recerca I3PT, Sabadell University Hospital (UAB), c/ Parc Taulí no. 1, 08208, Sabadell, Spain.
authors.forename: Assumpta
authors.initials: A
authors.lastname: Caixàs
authors.affiliation: Endocrinology and Nutrition Department, Morbid Obesity Unit, Hospital Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciudin
authors.affiliation: Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Avda. Rovira Roure 80, 25198, Lleida, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Bueno
authors.affiliation: U. Nutricion. U.G. Endocrinologia y Nutricion, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013, Sevilla, Spain.
authors.forename: Pedro Pablo
authors.initials: PP
authors.lastname: García-Luna
authors.affiliation: Endocrinology and Nutrition Department, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24001, León, Spain.
authors.forename: María D
authors.initials: MD
authors.lastname: Ballesteros-Pomar
authors.affiliation: Endocrinology and Nutrition Department, Hospital Regional Universitario Carlos Haya, Av. De Carlos Haya s/n, 29010, Málaga, Spain.
authors.forename: Marisol
authors.initials: M
authors.lastname: Ruiz-Adana
authors.affiliation: Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Avda. Rovira Roure 80, 25198, Lleida, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Lecube
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism; D015897:Comorbidity; D018849:Controlled Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Bariatric surgery; Metabolic control; Microvascular complications; Morbid obesity; Type 1 diabetes