PMID- 24062368
OWN - NLM
STAT- MEDLINE
DCOM- 20131129
LR  - 20220318
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Print)
IS  - 0031-4005 (Linking)
VI  - 132
IP  - 4
DP  - 2013 Oct
TI  - Bariatric surgery for severe obesity in two adolescents with type 1 diabetes.
PG  - e1031-4
LID - 10.1542/peds.2012-3640 [doi]
AB  - Bariatric surgery has been effective in treating type 2 diabetes mellitus (T2DM); 
      it has not been used frequently in obese patients with type 1 diabetes mellitus 
      (T1DM). This is the first case series reporting on the effect of bariatric 
      surgery on diabetes control in adolescents with T1DM. Patient A is a 19-year-old 
      obese man with T1DM who underwent vertical sleeve gastrectomy. At 12 months after 
      surgery he demonstrated 28% reduction in BMI. His daily total insulin requirement 
      had decreased; however, hemoglobin A1c remained primarily unchanged at 8.8%. 
      Patient B is a 13-year-old obese girl with an initial clinical diagnosis of T2DM 
      controlled on only metformin. She underwent Roux-en-Y gastric bypass; at 1 month 
      after surgery she presented in diabetic ketoacidosis and was found to have 
      positive islet cell antibodies, which were also present before surgery. Her 
      diagnosis was revised to T1DM, and she was started on insulin. By 28 months after 
      surgery her BMI had decreased by 42%. Since initiation of insulin, her daily 
      total insulin requirement had decreased, but hemoglobin A1c had significantly 
      worsened from 6.3% to 10%. We found that despite significant weight loss, 
      improvements in cardiovascular risk factors (dyslipidemia and obstructive sleep 
      apnea), and quality of life in our patients, bariatric surgery does not 
      necessarily lead to improved glycemic control of T1DM. Patients with T1DM have 
      ongoing dependency on exogenous insulin, and optimal glycemic control still 
      depends on patient compliance with diabetes care.
FAU - Chuang, Janet
AU  - Chuang J
AD  - Division of Endocrinology, Cincinnati Children's Hospital Medical Center, 3333 
      Burnet Avenue, MLC 7012, Cincinnati, OH 45229-3039. nancy.crimmins@cchmc.org.
FAU - Zeller, Meg H
AU  - Zeller MH
FAU - Inge, Thomas
AU  - Inge T
FAU - Crimmins, Nancy
AU  - Crimmins N
LA  - eng
GR  - UM1-DK095710/DK/NIDDK NIH HHS/United States
GR  - UM1 DK072493/DK/NIDDK NIH HHS/United States
GR  - UM1 DK095710/DK/NIDDK NIH HHS/United States
GR  - UL1 TR001425/TR/NCATS NIH HHS/United States
GR  - UL1 TR000077/TR/NCATS NIH HHS/United States
GR  - UM1-DK072493/DK/NIDDK NIH HHS/United States
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20130923
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
SB  - IM
MH  - Adolescent
MH  - *Bariatric Surgery/methods
MH  - Diabetes Mellitus, Type 1/*complications/diagnosis/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Obesity, Morbid/*complications/diagnosis/*surgery
MH  - Young Adult
PMC - PMC3784289
OTO - NOTNLM
OT  - adolescents
OT  - bariatric surgery
OT  - diabetes mellitus
OT  - type 1
EDAT- 2013/09/26 06:00
MHDA- 2013/12/16 06:00
PMCR- 2014/10/01
CRDT- 2013/09/25 06:00
PHST- 2013/09/25 06:00 [entrez]
PHST- 2013/09/26 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
PHST- 2014/10/01 00:00 [pmc-release]
AID - peds.2012-3640 [pii]
AID - 10.1542/peds.2012-3640 [doi]
PST - ppublish
SO  - Pediatrics. 2013 Oct;132(4):e1031-4. doi: 10.1542/peds.2012-3640. Epub 2013 Sep 
      23.