Impact of metabolic bariatric surgery on weight loss and glycemic control in adults with type 1 diabetes: a multicenter retrospective cohort study.

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Objective: To assess the effect of metabolic bariatric surgery (MBS) in people living with type 1 diabetes (T1D) and obesity. Research Design and Methods: From retrospective multicenter data, total weight loss, daily insulin requirement, HbA1c and cardiometabolic parameters were assessed pre-and post-surgery. Longitudinal models were used to identify response determinants. Results: 162 people living with T1D and obesity were included. One year after surgery, mean total weight loss was 29.7% [29.4-30.3]. Insulin requirements dropped from 0.75 [0.58-1.00] u/kg/day to 0.32 [0.23-0.43] u/kg/day (p<0.001) and HbA1c (64.0 [57.0-74.0] mmol/mol to 60.0 [53.4-68.0] mmol/mol; (p<0.001). LDL, HDL, total cholesterol and triglycerides significantly improved after surgery (p<0.001). Greater total weight loss was associated with reduced insulin requirements while higher baseline HbA1c was associated with poorer post-surgery glycemic-control. Conclusions: MBS was associated with substantial metabolic improvement in people with T1D and obesity, in particular in those with high HbA1c and insulin need at baseline.

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