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首页> 外文期刊>Therapeutic advances in endocrinology and metabolism. >Bariatric surgery in patients with type 1 diabetes: special considerations are warranted
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Bariatric surgery in patients with type 1 diabetes: special considerations are warranted

机译：1型糖尿病患者的减肥手术：需要特别考虑

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We examined short and long-term outcomes of bariatric surgery in patients with obesity and type 1 diabetes mellitus (T1DM). We reviewed the records of all adults insured by Maccabi Healthcare Services during 2010 -2015, with body mass index (BMI) ?30 kg/m2 and T1DM; and compared weight reduction and glucose control according to the performance of bariatric surgery. BMI and glycated hemoglobin (HbA1c) levels were extracted for baseline and every 6 months, for a mean 3.5 years. Of 52 patients, 26(50%) underwent bariatric surgery. Those who underwent surgery were more often female and with a longer duration of diabetes. Immediately postoperative, 4(15%) developed diabetic ketoacidosis, while 6(23%) experienced severe hypoglycemic episodes. The mean BMI decreased among surgery patients: from 39.5±4.4 to 30.1±5.0 kg/m2 (p 0.0001); and increased among those who did not undergo surgery: from 33.6±3.9 to 35.1±4.4 kg/m2 (p = 0.49). The mean HbA1c level decreased during the first 6 months postoperative: from 8.5±0.9% to 7.9±0.9%; however, at the end of follow-up, was similar to baseline, 8.6±2.0% (p = 0.87). For patients who did not undergo surgery, the mean HbA1c increased from 7.9±1.9% to 8.6±1.5% (p = 0.09). Among individuals with obesity and T1DM, weight loss was successful after bariatric surgery, but glucose control did not improve. The postoperative risks of diabetic ketoacidosis and severe hypoglycemic episodes should be considering when performing bariatric surgery in this population.
机译：我们检查了肥胖和1型糖尿病（T1DM）患者的减肥手术的短期和长期结果。我们回顾了2010年至2015年间Maccabi Healthcare Services所保所有成年人的身体质量指数（BMI）？30 kg / m2和T1DM的记录;并根据减肥手术的表现比较了减肥和血糖控制。基线和每6个月提取一次BMI和糖化血红蛋白（HbA1c）水平，平均3.5年。在52位患者中，有26位（50％）接受了减肥手术。那些接受手术的人通常是女性，糖尿病病程更长。术后立即发生糖尿病酮症酸中毒的发生率为4％（15％），而严重的降血糖事件为6％（23％）。手术患者的平均BMI下降：从39.5±4.4 kg / m2降至30.1±5.0 kg / m2（p <0.0001）;在未接受手术的患者中有所增加：从33.6±3.9 kg / m2增至35.1±4.4 kg / m2（p = 0.49）。术后头6个月HbA1c平均水平下降：从8.5±0.9％降至7.9±0.9％;然而，在随访结束时，与基线相似，为8.6±2.0％（p = 0.87）。对于未接受手术的患者，平均HbA1c从7.9±1.9％增加到8.6±1.5％（p = 0.09）。在肥胖和T1DM患者中，减肥手术后减肥成功，但血糖控制并未改善。在该人群中进行减肥手术时，应考虑糖尿病性酮症酸中毒和严重的低血糖发作的术后风险。

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