The increasing prevalence of obesity and metabolic syndrome in patients with type 1 diabetes necessitates the need for effective and evidence-based strategies in managing this emerging epidemic. Prevalence rates of obesity in type 1 diabetes vary worldwide and can range up to 20% in some centres [1]. Obesity in this cohort presents unique challenges with the development of insulin resistance and greater cardiometabolic risk in an already high-risk population. Bariatric surgery may provide an effective treatment option for these patients when target weight loss has not been attained with lifestyle measures and pharmacotherapy. However, the risks of diabetic ketoacidosis and severe hypoglycaemia associated with surgery, as well as the limited evidence for glycaemic benefit remain sizeable barriers for routine implementation of this strategy in type 1 diabetes patients.
Here we present an updated literature review on the potential benefits of bariatric surgery in the setting of type 1 diabetes, as well as case reports on the local experience of metabolic surgery in these patients. Identifying areas requiring further research in this field may help clarify the role of bariatric surgery as a potential treatment option in this complex patient population.