scholarly journals Potential benefits and harms of gastric bypass surgery in obese individuals with type 1 diabetes: a nationwide, matched, observational cohort study

2020 ◽  
Author(s):  
Gudrun Höskuldsdóttir ◽  
Jan Ekelund ◽  
Mervete Miftaraj ◽  
Ville Wallenius ◽  
Johan Ottosson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Substance Abuse ◽  
Gastric Bypass ◽  
Type 1 Diabetes ◽  
Cohort Study ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery

<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>

scholarly journals Potential benefits and harms of gastric bypass surgery in obese individuals with type 1 diabetes: a nationwide, matched, observational cohort study

2020 ◽  
Author(s):  
Gudrun Höskuldsdóttir ◽  
Jan Ekelund ◽  
Mervete Miftaraj ◽  
Ville Wallenius ◽  
Johan Ottosson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Substance Abuse ◽  
Gastric Bypass ◽  
Type 1 Diabetes ◽  
Cohort Study ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery

<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>

scholarly journals Potential Benefits and Harms of Gastric Bypass Surgery in Obese Individuals With Type 1 Diabetes: A Nationwide, Matched, Observational Cohort Study

Diabetes Care ◽  
2020 ◽  
Vol 43 (12) ◽  
pp. 3079-3085
Author(s):  
Gudrun Höskuldsdóttir ◽  
Jan Ekelund ◽  
Mervete Miftaraj ◽  
Ville Wallenius ◽  
Johan Ottosson ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Type 1 Diabetes ◽  
Cohort Study ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Observational Cohort Study ◽  
Potential Benefits ◽  
Observational Cohort

scholarly journals Potential Effects of Bariatric Surgery on the Incidence of Heart Failure and Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus and Obesity and on Mortality in Patients With Preexisting Heart Failure: A Nationwide, Matched, Observational Cohort Study

2021 ◽  
Author(s):  
Gudrún Höskuldsdóttir ◽  
Naveed Sattar ◽  
Mervete Miftaraj ◽  
Ingmar Näslund ◽  
Johan Ottosson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Type 2 Diabetes Mellitus ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery

Background Obesity and diabetes mellitus are strongly associated with heart failure (HF) and atrial fibrillation (AF). The benefits of bariatric surgery on cardiovascular outcomes are known in people with or without diabetes mellitus. Surgical treatment of obesity might also reduce the incidence of HF and AF in individuals with obesity and type 2 diabetes mellitus (T2DM). Methods and Results In this register‐based nationwide cohort study we compared individuals with T2DM and obesity who underwent Roux‐en‐Y gastric bypass surgery with matched individuals not treated with surgery. The main outcome measures were hospitalization for HF and/or AF and mortality in patients with preexisting HF. We identified 5321 individuals with T2DM and obesity who had undergone Roux‐en‐Y gastric bypass surgery between January 2007 and December 2013 and 5321 matched controls. The individuals included were 18 to 65 years old and had a body mass index >27.5 kg/m 2 . The follow‐up time for hospitalization was until the end of 2015 (mean 4.5 years) and the end of 2016 for death. Our results show a 73% lower risk for HF (hazard ratio [HR], 0.27; CI, 0.19–0.38), 41% for AF (HR, 0.59; CI, 0.44–0.78), and 77% for concomitant AF and HF (HR, 0.23; CI, 0.12–0.46) in the surgically treated group. In patients with preexisting HF we observed significantly lower mortality in the group who underwent surgery (HR, 0.23; 95% CI, 0.12–0.43). Conclusions Bariatric surgery may reduce risk for HF and AF in patients with T2DM and obesity, speculatively via positive cardiovascular and renal effects. Obesity treatment with surgery may also be a valuable alternative in selected patients with T2DM and HF.

scholarly journals Short-Term Insulin Requirements Following Gastric Bypass Surgery in Severely Obese Women with Type 1 Diabetes

2014 ◽  
Vol 24 (9) ◽  
pp. 1442-1446 ◽  
Author(s):  
Roeland J. W. Middelbeek ◽  
Tamarra James-Todd ◽  
Mary-Elizabeth Patti ◽  
Florence M. Brown
Keyword(s):  
Gastric Bypass ◽  
Type 1 Diabetes ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Obese Women ◽  
Short Term ◽  
Insulin Requirements ◽  
Severely Obese

Long-Term Results of Gastric Bypass Surgery in Morbidly Obese Type 1 Diabetes Patients

2010 ◽  
Vol 20 (4) ◽  
pp. 506-508 ◽  
Author(s):  
Leszek Czupryniak ◽  
Marcin Wiszniewski ◽  
Dariusz Szymański ◽  
Maciej Pawłowski ◽  
Jerzy Loba ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Type 1 Diabetes ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Long Term Results ◽  
Morbidly Obese ◽  
Diabetes Patients

scholarly journals Gastric Bypass Surgery in Severely Obese Women With Type 1 Diabetes: Anthropometric and Cardiometabolic Effects at 1 and 5 Years Postsurgery: Table 1

Diabetes Care ◽  
2015 ◽  
Vol 38 (7) ◽  
pp. e104-e105 ◽  
Author(s):  
Roeland J.W. Middelbeek ◽  
Tamarra James-Todd ◽  
Jerry D. Cavallerano ◽  
Deborah K. Schlossman ◽  
Mary Elizabeth Patti ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Type 1 Diabetes ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Obese Women ◽  
Severely Obese
Sign in / Sign up

Export Citation Format

Share Document