From the Guidelines
Gastric sleeve surgery is not a recommended treatment for type 1 diabetes, but it may be considered for weight management in obese individuals with type 1 diabetes, potentially improving insulin sensitivity and glycemic control. The current evidence suggests that metabolic surgery, including gastric sleeve surgery, is primarily recommended for individuals with type 2 diabetes and obesity, as it has been shown to achieve superior glycemic control and reduction of cardiovascular risk compared to nonsurgical interventions 1. However, the study notes that larger and longer-term studies are needed to determine the role of metabolic surgery in individuals with type 1 diabetes 1.
Some key points to consider:
- Gastric sleeve surgery may help with weight management and potentially improve insulin sensitivity in obese individuals with type 1 diabetes, leading to better glycemic control and reduced insulin requirements.
- Weight loss after gastric sleeve surgery decreases insulin resistance in peripheral tissues, allowing injected insulin to work more effectively.
- Despite potential benefits, gastric sleeve surgery is not a cure for type 1 diabetes, and patients will still require lifelong insulin therapy.
- Any consideration of gastric sleeve surgery for a person with type 1 diabetes should involve a multidisciplinary team, including an endocrinologist, bariatric surgeon, and dietitian, to carefully manage the complex interplay between diabetes management and post-surgical care.
It's essential to prioritize the management of type 1 diabetes and consider the potential benefits and risks of gastric sleeve surgery in the context of overall health and well-being, rather than as a treatment for the underlying autoimmune condition 1.
From the Research
Association between Gastric Sleeve and Type 1 Diabetes
- The current evidence on the association between gastric sleeve surgery and type 1 diabetes is limited and inconclusive 2, 3.
- A study published in 2017 found that laparoscopic sleeve gastrectomy resulted in significant weight loss and reduction in insulin doses in patients with type 1 diabetes, but did not improve glycemic control 2.
- Another study published in 2015 found that bariatric surgery, including gastric sleeve, did not improve glycemic control in patients with type 1 diabetes, but did improve weight loss and reduce the number of medications needed 3.
- A review of surgical options for type 1 diabetes published in 2019 discussed the potential benefits and limitations of bariatric surgery, including gastric sleeve, but noted that the use of surgery in type 1 diabetes remains unestablished and controversial 4.
- There is no direct evidence on the specific effects of gastric sleeve surgery on type 1 diabetes, and more research is needed to fully understand the relationship between the two 5, 4, 2, 3.
Key Findings
- Significant weight loss and reduction in insulin doses were observed in patients with type 1 diabetes who underwent gastric sleeve surgery 2.
- No improvement in glycemic control was found in patients with type 1 diabetes who underwent bariatric surgery, including gastric sleeve 2, 3.
- Bariatric surgery, including gastric sleeve, may be beneficial for weight loss and reducing the number of medications needed, but its effects on glycemic control in type 1 diabetes are unclear 4, 3.
Gaps in Research
- There is a need for more research on the specific effects of gastric sleeve surgery on type 1 diabetes, including its impact on glycemic control and insulin requirements 5, 4, 2, 3.
- Larger, long-term studies are needed to fully understand the relationship between gastric sleeve surgery and type 1 diabetes 2, 3.