<b>Objective:</b> To study the potential long‑term benefits and possible complications of bariatric surgery in patients
with type 1 diabetes.
<p> </p>
<p><b>Research Design and Methods:</b> In this register‑based nationwide cohort study we compared individuals with T1D and
obesity that underwent Roux‑en‑Y gastric bypass surgery (RYGB) with patients with T1D and obesity matched
for age, gender, BMI and calendar time that did not undergo surgery. By linking
the Swedish National Diabetes Register and Scandinavian Obesity Surgery
Registry study individuals were included between 2007 and 2013. Outcomes examined
included all-cause mortality, cardiovascular disease, stroke, heart failure and
hospitalization for serious hypo‑ or hyperglycemic events, amputation, psychiatric disorders, changes in
kidney function and substance abuse.</p>
<p> </p>
<p><b>Results:</b> We identified 387 individuals that had
undergone RYGB and 387 controls. Follow‑up for hospitalization was up to 9 years. Analysis showed lower risk for
cardiovascular disease (HR 0.43, 95% CI 0.20‑0.9), cardiovascular death (HR 0.15, 95% CI 0.03-0.68), hospitalization
for heart failure (HR 0.32, 95% CI 0.15‑0.67) and stroke (HR 0.18, 95% CI 0.04-0.82) for the RYGB group. There
was a higher risk for serious hyperglycemic events (HR 1.99, 95% CI 1.07‑3.72) and substance abuse (HR
3.71, 95% CI 1.03-3.29) after surgery. </p>
<p> </p>
<p><b>Conclusion:</b> This observational study suggests bariatric surgery may yield similar benefits on
risk for cardiovascular outcomes and mortality in patients with T1D and obesity as for
patients with type 2 diabetes. However, some potential
serious adverse effects suggest need for careful monitoring of such patients after
surgery. </p>