Impact of metabolic and bariatric surgery on weight loss and insulin requirements in type 1 and insulin-treated type 2 diabetes

IF 2.2 Q3 ENDOCRINOLOGY & METABOLISM Clinical Obesity Pub Date : 2024-06-27 DOI:10.1111/cob.12689

Kamal Abi Mosleh, Yara Salameh, Wissam Ghusn, Noura Jawhar, Manpreet S. Mundi, Maria L. Collazo-Clavell, Michael L. Kendrick, Omar M. Ghanem

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Abstract

Metabolic and Bariatric Surgery (MBS) is effective in improving metabolic outcomes and reducing weight in patients with obesity and diabetes, with less explored benefits in type 1 diabetes (T1D). This study aimed to evaluate the impact of MBS on weight loss and insulin requirements in T1D patients compared to insulin-treated type 2 diabetes (T2D) patients over a 5-year period. This retrospective analysis included patients who underwent primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) with a confirmed preoperative diagnosis of either T1D or insulin-treated T2D. Primary endpoints focusing on weight loss and secondary outcomes assessing changes in insulin dosage and glycemic control. After 5 years, weight loss was similar across groups, with total weight loss at 14.2% for T1D and 17.6% for insulin-treated T2D in SG, and 22.6% for T1D vs. 26.8% for insulin-treated T2D in RYGB. Additionally, there was a significant reduction in median daily insulin doses from 140.5 units at baseline to 77.5 units at 1 year postoperatively, sustained at 90 units at 5 years. The differential impact of MBS procedure was also highlighted, where RYGB patients showed a more pronounced and enduring decrease in insulin requirements compared to SG.

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代谢和减肥手术对 1 型糖尿病和接受胰岛素治疗的 2 型糖尿病患者体重减轻和胰岛素需求量的影响。

代谢与减肥手术（MBS）能有效改善肥胖症和糖尿病患者的代谢结果并减轻体重，但对 1 型糖尿病（T1D）患者的益处探索较少。本研究旨在评估与接受胰岛素治疗的 2 型糖尿病 (T2D) 患者相比，MBS 在 5 年内对 T1D 患者体重减轻和胰岛素需求量的影响。这项回顾性分析纳入了接受原发性袖带胃切除术（SG）或Roux-en-Y胃旁路术（RYGB）、术前确诊为T1D或胰岛素治疗的T2D的患者。主要终点是体重减轻，次要结果是评估胰岛素用量和血糖控制的变化。5 年后，各组的体重减轻情况相似，SG 组 T1D 和胰岛素治疗 T2D 的总体重减轻率分别为 14.2% 和 17.6%，RYGB 组 T1D 和胰岛素治疗 T2D 的总体重减轻率分别为 22.6% 和 26.8%。此外，胰岛素日剂量中位数从基线时的 140.5 单位显著降至术后 1 年的 77.5 单位，5 年后仍保持在 90 单位。MBS 手术的不同影响也得到了强调，与 SG 相比，RYGB 患者的胰岛素需求量下降更明显、更持久。

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来源期刊

Clinical Obesity ENDOCRINOLOGY & METABOLISM-

CiteScore

5.90

自引率

3.00%

发文量

期刊介绍： Clinical Obesity is an international peer-reviewed journal publishing high quality translational and clinical research papers and reviews focussing on obesity and its co-morbidities. Key areas of interest are: • Patient assessment, classification, diagnosis and prognosis • Drug treatments, clinical trials and supporting research • Bariatric surgery and follow-up issues • Surgical approaches to remove body fat • Pharmacological, dietary and behavioural approaches for weight loss • Clinical physiology • Clinically relevant epidemiology • Psychological aspects of obesity • Co-morbidities • Nursing and care of patients with obesity.