Gastric Bypass Surgery in Severely Obese Type 1 Diabetic Patients
- Leszek Czupryniak, MD, PHD1,
- Janusz Strzelczyk, MD, PHD2,
- Katarzyna Cypryk, MD, PHD3,
- Maciej Pawlowski, MD1,
- Dariusz Szymanski, MD, PHD2,
- Andrzej Lewinski, MD, PHD3 and
- Jerzy Loba, MD, PHD1
- 1Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
- 2Department of General and Transplant Surgery, Medical University of Lodz, Lodz, Poland
- 3Department of Endocrinology and Isotope Therapy, Polish Mother’s Memorial Hospital Research Institute, Medical University of Lodz, Lodz, Poland
- Address correspondence to Leszek Czupryniak, MD, PHD, Department of Diabetology and Metabolic Diseases, Barlicki University Hospital, No. 1, Ul, Kopcinskiego 22, 90-153 Lodz, Poland. E-mail: bigosik{at}poczta.onet.pl
Obesity is common in type 2 diabetes but is rarely seen in autoimmune type 1 diabetes (1). However, as shown in the Diabetes Control and Complications Trial cohort (2,3), a subset of type 1 diabetic patients are overweight, and it has been suggested that intensive insulin therapy may unmask the central obesity or metabolic syndrome in susceptible individuals.
Gastric bypass is considered a gold standard procedure in the surgical treatment of severe obesity, with >50% of excess weight loss occurring within 2 years after the surgery. The weight reduction is maintained over the following years in a vast majority of patients (4). Numerous reports have been published on the beneficial effects of obesity surgery on glucose control and metabolic disorders in impaired glucose tolerant and type 2 diabetic subjects, with an impressive 70–90% of diabetic patients remaining euglycemic without diabetes medications several years after the surgery (5,6). This significant impact of gastric bypass surgery on glucose control is thought to not only result from significant weight loss but also from the exclusion of hormonally active foregut (7, …
