Metabolic and bariatric surgery for patients with obesity type 1 diabetes mellitus: A comprehensive updated systematic review and meta‐analysis
Authors' conclusion
MBS achieves weight loss and reduces insulin requirements in adults with type 1 diabetes mellitus and obesity, but glycaemic improvements are minimal. Given the observational evidence base and inconsistent safety reporting, true metabolic risk remains uncertain. High-quality prospective studies with standardised outcome definitions are needed.
Study context
- Population
- Adults with T1D and obesity; mean age 42.2 ± 11.6 years; mean follow-up 31.6 ± 18.2 months
- Participants
- 1,324 adults22 studies
- Comparison
- Before vs after metabolic and bariatric surgery (MBS)
- Outcome
- Changes in body weight, BMI, HbA1c and insulin requirements following MBS
Methodological detailsPRISMA-compliant, PROSPERO-registered, Risk of bias assessed with ROBINS-I and RoB-2; certainty of evidence with GRADE
- PRISMA-compliant
- PROSPERO-registered
- Risk of bias assessed with ROBINS-I and RoB-2; certainty of evidence with GRADE
Pooled result
As reported in the abstract
Body weight reduction, MD
29.55 kg
95% CI 25.72 to 33.39; I2 = 20%
BMI reduction
11.35 kg/m²
95% CI 10.36 to 12.34; I2 = 32%
HbA1c decrease
4 mmol/mol
95% CI 2.05 to 6.78; I2 = 19%
Insulin requirements decline
43%-48%
0.20 U/kg; 95% CI 0.13 to 0.26; I2 = 58%
Safety
Postoperative complications
- DKA
- 15/182, 8%
- Severe hypoglycaemia
- 21/516, 4%
- Any complication
- 21/495 (4%)
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →