Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study

Rieneke van der Meer; Sofia Pazmino; Nele Steenackers; Amar van Laar; Maarten Sluis; Luna Tolenaars; Jonathan Rosen; Carmen Hurtado del Pozo; Carel W. le Roux; Jumana Al Kandari; Mohammad Irshad; Matthias Lannoo; Ellen Deleus; Bruno Dillemans; Yves Van Nieuwenhove; Arianne van Bon; Eric Hazebroek; Ebaa Al Ozairi; Roel Hoogma; Chantal Mathieu; Ronald Liem; Bart Van der Schueren

doi:10.2337/dc25-2295

Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study

Rieneke van der Meer
, Sofia Pazmino
, Nele Steenackers
, Amar van Laar
, Maarten Sluis
, Luna Tolenaars
, Jonathan Rosen
, Carmen Hurtado del Pozo
, Carel W. le Roux
, Jumana Al Kandari
, Mohammad Irshad
, Matthias Lannoo
, Ellen Deleus
, Bruno Dillemans
, Yves Van Nieuwenhove
, Arianne van Bon
, Eric Hazebroek
, Ebaa Al Ozairi
, Roel Hoogma
, Chantal Mathieu

Ronald Liem, Bart Van der Schueren

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To assess the effect of metabolic bariatric surgery (MBS) in people living with type 1 diabetes (T1D) and obesity. RESEARCH DESIGN AND METHODS: From retrospective multicenter data, total weight loss, daily insulin requirement, HbA1c, and cardiometabolic parameters were assessed before and after surgery. Longitudinal models were used to identify response determinants. RESULTS: This study included 162 people living with T1D and obesity. One year after surgery, mean total weight loss percentage was 29.7% (interquartile range [IQR] = 29.4, 30.3). Insulin requirements dropped from 0.75 (IQR = 0.58, 1.00) units/kg/day to 0.32 (IQR = 0.23, 0.43) units/kg/day (P < 0.001), and HbA1c dropped from 64.0 (IQR = 57.0, 74.0) mmol/mol to 60.0 (IQR = 53.4, 68.0) mmol/mol (P < 0.001). LDL, HDL, total cholesterol, and triglyceride levels significantly improved after surgery (P < 0.001). Greater total weight loss was associated with reduced insulin requirements, and higher baseline HbA1c was associated with poorer postsurgery glycemic control. CONCLUSIONS: MBS was associated with substantial metabolic improvement in people with T1D and obesity, in particular in those with high HbA1c and insulin need at baseline.

Original language	English
Pages (from-to)	658–663
Number of pages	6
Journal	Diabetes Care
Volume	49
Issue number	4
Early online date	18 Feb 2026
DOIs	https://doi.org/10.2337/dc25-2295
Publication status	Published (in print/issue) - 1 Apr 2026

Bibliographical note

Publisher Copyright:
© 2026 by the American Diabetes Association.

Funding

SOPHIA has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (grant 875534), supported by the European Union’s Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associations (EFPIA), with additional support from T1D Exchange, Breakthrough T1D (formerly JDRF), and Obesity Action Coalition. The Nederlandse Obesitas Kliniek (NOK) received funding from Medtronic for the conduct of this study.

Funders	Funder number
Obesity Action Coalition
MEDTRONIC
875534

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Adult
Bariatric Surgery
Blood Glucose/metabolism
Diabetes Mellitus, Type 1/surgery
Female
Glycated Hemoglobin/metabolism
Glycemic Control
Humans
Insulin/therapeutic use
Male
Middle Aged
Obesity/surgery
Retrospective Studies
Weight Loss/physiology

Access to Document

10.2337/dc25-2295

Cite this

van der Meer, R., Pazmino, S., Steenackers, N., van Laar, A., Sluis, M., Tolenaars, L., Rosen, J., Hurtado del Pozo, C., le Roux, C. W., Al Kandari, J., Irshad, M., Lannoo, M., Deleus, E., Dillemans, B., Van Nieuwenhove, Y., van Bon, A., Hazebroek, E., Al Ozairi, E., Hoogma, R., ... Van der Schueren, B. (2026). Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study. Diabetes Care, 49(4), 658–663 . https://doi.org/10.2337/dc25-2295

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title = "Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study",

abstract = "OBJECTIVE: To assess the effect of metabolic bariatric surgery (MBS) in people living with type 1 diabetes (T1D) and obesity. RESEARCH DESIGN AND METHODS: From retrospective multicenter data, total weight loss, daily insulin requirement, HbA1c, and cardiometabolic parameters were assessed before and after surgery. Longitudinal models were used to identify response determinants. RESULTS: This study included 162 people living with T1D and obesity. One year after surgery, mean total weight loss percentage was 29.7\% (interquartile range [IQR] = 29.4, 30.3). Insulin requirements dropped from 0.75 (IQR = 0.58, 1.00) units/kg/day to 0.32 (IQR = 0.23, 0.43) units/kg/day (P < 0.001), and HbA1c dropped from 64.0 (IQR = 57.0, 74.0) mmol/mol to 60.0 (IQR = 53.4, 68.0) mmol/mol (P < 0.001). LDL, HDL, total cholesterol, and triglyceride levels significantly improved after surgery (P < 0.001). Greater total weight loss was associated with reduced insulin requirements, and higher baseline HbA1c was associated with poorer postsurgery glycemic control. CONCLUSIONS: MBS was associated with substantial metabolic improvement in people with T1D and obesity, in particular in those with high HbA1c and insulin need at baseline.",

keywords = "Adult, Bariatric Surgery, Blood Glucose/metabolism, Diabetes Mellitus, Type 1/surgery, Female, Glycated Hemoglobin/metabolism, Glycemic Control, Humans, Insulin/therapeutic use, Male, Middle Aged, Obesity/surgery, Retrospective Studies, Weight Loss/physiology",

author = "\{van der Meer\}, Rieneke and Sofia Pazmino and Nele Steenackers and \{van Laar\}, Amar and Maarten Sluis and Luna Tolenaars and Jonathan Rosen and \{Hurtado del Pozo\}, Carmen and \{le Roux\}, \{Carel W.\} and \{Al Kandari\}, Jumana and Mohammad Irshad and Matthias Lannoo and Ellen Deleus and Bruno Dillemans and \{Van Nieuwenhove\}, Yves and \{van Bon\}, Arianne and Eric Hazebroek and \{Al Ozairi\}, Ebaa and Roel Hoogma and Chantal Mathieu and Ronald Liem and \{Van der Schueren\}, Bart",

note = "Publisher Copyright: {\textcopyright} 2026 by the American Diabetes Association.",

year = "2026",

month = apr,

day = "1",

doi = "10.2337/dc25-2295",

language = "English",

volume = "49",

pages = "658–663 ",

journal = "Diabetes Care",

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publisher = "American Diabetes Association ",

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van der Meer, R, Pazmino, S, Steenackers, N, van Laar, A, Sluis, M, Tolenaars, L, Rosen, J, Hurtado del Pozo, C, le Roux, CW, Al Kandari, J, Irshad, M, Lannoo, M, Deleus, E, Dillemans, B, Van Nieuwenhove, Y, van Bon, A, Hazebroek, E, Al Ozairi, E, Hoogma, R, Mathieu, C, Liem, R & Van der Schueren, B 2026, 'Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study', Diabetes Care, vol. 49, no. 4, pp. 658–663 . https://doi.org/10.2337/dc25-2295

TY - JOUR

T1 - Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study

AU - van der Meer, Rieneke

AU - Pazmino, Sofia

AU - Steenackers, Nele

AU - van Laar, Amar

AU - Sluis, Maarten

AU - Tolenaars, Luna

AU - Rosen, Jonathan

AU - Hurtado del Pozo, Carmen

AU - le Roux, Carel W.

AU - Al Kandari, Jumana

AU - Irshad, Mohammad

AU - Lannoo, Matthias

AU - Deleus, Ellen

AU - Dillemans, Bruno

AU - Van Nieuwenhove, Yves

AU - van Bon, Arianne

AU - Hazebroek, Eric

AU - Al Ozairi, Ebaa

AU - Hoogma, Roel

AU - Mathieu, Chantal

AU - Liem, Ronald

AU - Van der Schueren, Bart

PY - 2026/4/1

Y1 - 2026/4/1

N2 - OBJECTIVE: To assess the effect of metabolic bariatric surgery (MBS) in people living with type 1 diabetes (T1D) and obesity. RESEARCH DESIGN AND METHODS: From retrospective multicenter data, total weight loss, daily insulin requirement, HbA1c, and cardiometabolic parameters were assessed before and after surgery. Longitudinal models were used to identify response determinants. RESULTS: This study included 162 people living with T1D and obesity. One year after surgery, mean total weight loss percentage was 29.7% (interquartile range [IQR] = 29.4, 30.3). Insulin requirements dropped from 0.75 (IQR = 0.58, 1.00) units/kg/day to 0.32 (IQR = 0.23, 0.43) units/kg/day (P < 0.001), and HbA1c dropped from 64.0 (IQR = 57.0, 74.0) mmol/mol to 60.0 (IQR = 53.4, 68.0) mmol/mol (P < 0.001). LDL, HDL, total cholesterol, and triglyceride levels significantly improved after surgery (P < 0.001). Greater total weight loss was associated with reduced insulin requirements, and higher baseline HbA1c was associated with poorer postsurgery glycemic control. CONCLUSIONS: MBS was associated with substantial metabolic improvement in people with T1D and obesity, in particular in those with high HbA1c and insulin need at baseline.

AB - OBJECTIVE: To assess the effect of metabolic bariatric surgery (MBS) in people living with type 1 diabetes (T1D) and obesity. RESEARCH DESIGN AND METHODS: From retrospective multicenter data, total weight loss, daily insulin requirement, HbA1c, and cardiometabolic parameters were assessed before and after surgery. Longitudinal models were used to identify response determinants. RESULTS: This study included 162 people living with T1D and obesity. One year after surgery, mean total weight loss percentage was 29.7% (interquartile range [IQR] = 29.4, 30.3). Insulin requirements dropped from 0.75 (IQR = 0.58, 1.00) units/kg/day to 0.32 (IQR = 0.23, 0.43) units/kg/day (P < 0.001), and HbA1c dropped from 64.0 (IQR = 57.0, 74.0) mmol/mol to 60.0 (IQR = 53.4, 68.0) mmol/mol (P < 0.001). LDL, HDL, total cholesterol, and triglyceride levels significantly improved after surgery (P < 0.001). Greater total weight loss was associated with reduced insulin requirements, and higher baseline HbA1c was associated with poorer postsurgery glycemic control. CONCLUSIONS: MBS was associated with substantial metabolic improvement in people with T1D and obesity, in particular in those with high HbA1c and insulin need at baseline.

KW - Adult

KW - Bariatric Surgery

KW - Blood Glucose/metabolism

KW - Diabetes Mellitus, Type 1/surgery

KW - Female

KW - Glycated Hemoglobin/metabolism

KW - Glycemic Control

KW - Humans

KW - Insulin/therapeutic use

KW - Male

KW - Middle Aged

KW - Obesity/surgery

KW - Retrospective Studies

KW - Weight Loss/physiology

UR - https://www.scopus.com/pages/publications/105033976790

U2 - 10.2337/dc25-2295

DO - 10.2337/dc25-2295

M3 - Article

C2 - 41706050

SN - 0149-5992

VL - 49

SP - 658

EP - 663

JO - Diabetes Care

JF - Diabetes Care

IS - 4

ER -

Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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