Impact of bariatric surgery and weight loss medications in adults with type 1 diabetes in the T1D Exchange Clinic Registry

Francesco Vendrame, Peter Calhoun, Laura E. Bocchino, Richard E. Pratley, Anna Casu

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To investigate the impact of bariatric surgery and weight loss medications in adults with type 1 diabetes. Materials and methods: Subjects enrolled in the T1D Exchange (T1DX) Clinic Registry age ≥ 18 years with a diabetes duration of ≥1 year were included in the analysis (n = 13,501). Data for participants (n = 37) with bariatric surgery after diabetes onset were assessed before and after surgery and also compared to a matched control group. Data for participants who reported the use of FDA-approved weight loss medications (n = 483) were assessed before starting, during use, and after stopping the medications and also compared to a matched control group. Variables of interest included BMI, HbA1c, blood pressure, lipid profile, rates of acute complications. Data were analyzed using linear mixed models. Results: Bariatric surgery resulted in BMI reduction from 38.8 ± 9.1 kg/m2 to 33.3 ± 6.7 kg/m2 (P = 0.006) and HbA1c reduction from 8.8 ± 1.3% (73 ± 14.2 mmol/mol) to 8.1 ± 1.1% (65 ± 12.0 mmol/mol) (P = 0.05). Weight loss medications were not associated with weight loss or better glycemic control although stopping liraglutide favored weight gain. Both interventions were not associated with a significant change in blood pressure or lipid profile. There were no adverse events associated with the use of weight loss medications. Conclusions: Bariatric surgery is effective for weight loss and may improve glycemic control in selected patients. Weight loss medications are not associated with diabetes improvement. A trial with liraglutide may be attempted for weight control, but weight loss medications in general do not show a significant effect.

Original languageEnglish (US)
Article number107884
JournalJournal of Diabetes and Its Complications
Volume35
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • BMI
  • Obesity
  • Obesity treatment
  • Type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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