The effect of metabolic surgery on type 1 diabetes: Meta-analysis

Abstract

Objective: Metabolic and bariatric surgery has a definite role in the management of obese patients with type 2 diabetes mellitus (T2DM). There is also evidence of such surgery improving the health of type 1 diabetic (T1DM) patients. The aim of this paper is to explore the effect of metabolic and bariatric surgery on T1DM. Materials and methods: A comprehensive search of PubMed and Google Scholar was performed to identify relevant papers reporting metabolic and bariatric surgery effects on T1DM. A statistical analysis is applied after data synthesis. A forest plot and Pearson correlation are then calculated. Results: Of the 567 papers that were identified, 558 articles did not fulfill the inclusion criteria and were therefore excluded. Nine studies involving 78 patients were selected for this meta-analysis. There was improvement in HBA1c (p value = 0.40), insulin dose (p value = 0.0001) and BMI (p value = 0.00001) after surgery. However, improvement in the HBA1c did not reach statistical significance. There was a weak correlation between postoperative insulin dose and BMI change after surgery (r = -0.177). There was a negligible correlation between HBA1c and BMI change after operations (r = -0.01). Conclusion: Current metabolic/bariatric surgery is improving T1DM in obese and morbidly obese patients. This is not exclusively related to excess weight loss (EWL) as previously thought. Therefore, there is a role for other factors, which are potential players to reproduce the same effect in nonobese T1DM patients.