Diabetic Ketoacidosis Common After Bariatric Surgery
Patients with type 1 diabetes are more likely to develop severe diabetic ketoacidosis (DKA) following bariatric surgery than patients with type 2 diabetes, according to a new study.
Bariatric surgery is a common treatment for patients with obesity and diabetes, and although DKA is a frequent complication following bariatric surgery, little is known about what causes it.
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To clarify their understanding, researchers collected data from 12 patients who developed DKA within the 3 months after bariatric surgery at the Cleveland Clinic from 2005 to 2015.
Before surgery, 8 patients with type 1 diabetes and 4 with type 2 diabetes were self-managing insulin intake but had poor glycemic control. Patients underwent laparoscopic gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding.
After assessing perioperative data, researchers found that, of all patients receiving bariatric surgery at the Cleveland Clinic, 25% of patients with type 1 diabetes and 0.2% of patients with type 2 diabetes developed postsurgery DKA.
DKA symptoms—including nausea, vomiting, and abdominal pain—were more severe in patients with type 1 diabetes than in those with type 2 diabetes.
“Early detection and aggressive diabetes care are needed to treat this serious adverse event,” researchers concluded.
—Amanda Balbi
Reference:
Aminian A, Kashyap SR, Burguera B, et al. Incidence and clinical features of diabetic ketoacidosis after bariatric and metabolic surgery. Diabetes Care. Published online before print January 28, 2016. doi:10.2337/dc15-2647.