Figure 2: Course of HbA1c. Figure 3: Development of total amount of insulin per day (IU). Pat. 1 Pat. 2 Pat. 3 Pat. 4 Pat. 5 Pat. 6 Pat. 7 Pat. 8 Pat. 9 Pat. 10.
Obesity and metabolic surgery in type 1 diabetes mellitus Christine Stier, Heike Raab, Michael Frenken and Rudolf Weiner Department of Surgery, Krankenhaus Sachsenhausen, Frankfurt am Main, Germany
60
Introduction
55 Pat. 1
50
BMI (kg/m2)
The prevalence of obesity and type 2 diabetes mellitus is increasing worldwide. Obesity surgery is an effective method for treating obesity and diabetes type 2. But little is known about bariatric surgery in type 1 diabetes.
Pat. 2 Pat. 3
45
Pat. 4 Pat. 5
40
Pat. 6 Pat. 7
35
Pat. 8 30
Pat. 9 Pat. 10
25
Methods
20 presurg.
4 w. p-s.
3 mo p-s.
6 mo p-s.
1 yr p-s.
2 yr p-s.
3 yr p-s.
4 yr p-s.
Figure 1: Course of BMI
We report of eight female patients with diabetes mellitus type 1 who underwent bariatric surgery (Table 1).
12
11 Pat. 1
Results
10
Pat. 2 Pat. 3
HbA1c (%)
BMI decreased in each patient as expected for patients without diabetes (figure 1). The course of HbA1c and the development of total amount of insulin requirement are shown in Figure 2 and Figure 3, respectively.
Figure 3: Development of total amount of insulin per day (IU)
Conclusion
Obesity surgery induces an improvement of weight and insulin sensitivity in morbidly obese patients with type 1 diabetes mellitus. Thus, obesity surgery is an effective treatment not only for type 2 diabetes but also for obese type 1 diabetes patients. However, an optimal blood glucose control still remains very important in the therapy of diabetes type 1 to avoid long-term complications.
