Journal ArticleDOI
Long-Term Outcomes in Patients with Morbid Obesity and Type 1 Diabetes Undergoing Bariatric Surgery
Nuria Vilarrasa,Miguel A. Rubio,Inka Miñambres,Lillian Flores,Assumpta Caixàs,Andrea Ciudin,Marta Bueno,Pedro Pablo García-Luna,María D. Ballesteros-Pomar,Marisol Ruiz-Adana,Albert Lecube +10 more
TLDR
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.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/m2 were 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). HbA1c was reduced during the first year from 8.5 ± 1.3 to 7.9 ± 1.4 %, p = 0.016. In the long-term, HbA1c returned 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.read more
Citations
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Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Emelia J. Benjamin,Paul Muntner,Alvaro Alonso,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Alex R. Chang,Susan Cheng,Sandeep R Das,Francesca N. Delling,Luc Djoussé,Mitchell S.V. Elkind,Jane F. Ferguson,Myriam Fornage,Lori C. Jordan,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Tak W. Kwan,Daniel T. Lackland,Tené T. Lewis,Judith H. Lichtman,Chris T. Longenecker,Matthew Shane Loop,Pamela L. Lutsey,Seth S. Martin,Kunihiro Matsushita,Andrew E. Moran,Michael E. Mussolino,Martin O'Flaherty,Ambarish Pandey,Amanda M. Perak,Wayne D. Rosamond,Gregory A. Roth,Uchechukwu K.A. Sampson,Gary Satou,Emily B. Schroeder,Svati H. Shah,Nicole L. Spartano,Andrew Stokes,David L. Tirschwell,Connie W. Tsao,Mintu P. Turakhia,Lisa B. VanWagner,John T. Wilkins,Sally S. Wong,Salim S. Virani +47 more
TL;DR: March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee.
Journal ArticleDOI
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Salim S. Virani,Alvaro Alonso,Emelia J. Benjamin,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Alex R. Chang,Susan Cheng,Francesca N. Delling,Luc Djoussé,Mitchell S.V. Elkind,Jane F. Ferguson,Myriam Fornage,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Tak W. Kwan,Daniel T. Lackland,Tené T. Lewis,Judith H. Lichtman,Chris T. Longenecker,Matthew Shane Loop,Pamela L. Lutsey,Seth S. Martin,Kunihiro Matsushita,Andrew E. Moran,Michael E. Mussolino,Amanda M. Perak,Wayne D. Rosamond,Gregory A. Roth,Uchechukwu K.A. Sampson,Gary Satou,Emily B. Schroeder,Svati H. Shah,Christina M. Shay,Nicole L. Spartano,Andrew Stokes,David L. Tirschwell,Lisa B. VanWagner,Connie W. Tsao +40 more
TL;DR: This year's edition of the Statistical Update includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association’s 2020 Impact Goals.
Journal ArticleDOI
Non-pharmacological Treatment Options in the Management of Diabetes Mellitus
TL;DR: This review summarises the current evidence base for the non-pharmacological interventions in the management of diabetes and finds them useful for the effective management of even type 1 diabetes mellitus when used along with insulin therapy especially in those with obesity.
Journal ArticleDOI
Aktuelles zur Adipositas (mit und ohne Diabetes)
TL;DR: Pharmacotherapy does not yet play a role that would presumably be necessary in order to improve the results of conservative treatment of obesity, and recently published studies with favorable data support the use of surgical strategies in obese subjects when indicated.
References
More filters
Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Standards of medical care in diabetes.
TL;DR: I would like to take issue with the use of the phrase “standards of medical care in diabetes,” which is used to describe diabetes care standards, in the recently updated and circulatedADA 2006 Clinical Practice Recommendations.
Journal ArticleDOI
Bariatric surgery: a systematic review and meta-analysis.
Henry Buchwald,Yoav Avidor,Eugene Braunwald,Michael D. Jensen,Walter J. Pories,Kyle Fahrbach,Karen Schoelles +6 more
TL;DR: Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery, and a substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.
Journal ArticleDOI
Standards of Medical Care in Diabetes: Response to Power
TL;DR: The title “Standards of Medical Care in Diabetes” was chosen because in the view of the American Diabetes Association (ADA), the recommendations represent what the association considers the “standards” for the care of patients with diabetes.
Journal ArticleDOI
Standards of Medical Care in Diabetes—2012
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payers, and other interested individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care.