Abstract
Bariatric surgery has emerged as a viable treatment option in morbidly obese individuals with type 2 diabetes. Concomitant with societal lifestyle changes and the increased emphasis on achieving metabolic targets, there has been a rise in the number of patients with type 1 diabetes (T1DM) who are overweight and obese. Preliminary experience based on a limited number of observational reports points to substantial weight loss and amelioration of comorbid conditions such as blood pressure and dyslipidemia in patients with T1DM who undergo weight loss surgery. However, there is little evidence to suggest significant improvement in glycemic control and lowering of glycosylated hemoglobin, and bariatric surgical procedures do not necessarily lead to enhanced diabetes management. and improved quality of life. The potential possibility of micronutrient deficiency, weight regain, and psychobehavioral issues post-bariatric surgery also exists. An individualized evaluation of the risks and benefits should be considered, using a a multidisciplinary team approach with expertise in patient selection, surgical technique, and follow-up. A crucial component is the availability of a diabetes care specialist or endocrinologist experienced in intensive, tailored, modifiable insulin regimens who maintains close and careful monitoring during all phases of management. Reliable data from a prospective, longitudinal perspective is required to provide guidelines for clinicians and informed choices for obese patients with T1DM who are contemplating bariatric surgery.
Highlights
In the United States, breast cancer is the most common cancer excluding non-melanoma skin cancers among women [1]
This study looked at the association between the development of lymphedema and treatment and personal risk factors among a cohort of women diagnosed with breast cancer in Iowa during 2004 and followed through 2010 for symptoms of lymphedema
Participants with a body mass index (BMI) ≥30 (35.9%) were more likely to develop lymphedema (RR=2.15, 95% confidence intervals (95% CI): 1.35, 3.42) than those with a BMI
Summary
In the United States, breast cancer is the most common cancer excluding non-melanoma skin cancers among women [1]. Lymphedema of the arm (here forward referred to as lymphedema) is believed to be a treatment complication that adversely affects breast cancer survivors. There is conflicting information regarding which treatments are risk factors and limited research on other risk factors for lymphedema. Lymphedema causes the accumulation of fluid (swelling) in the arm and 15-20% of breast cancer survivors are expected to develop this condition in their lifetimes [4]. Breast cancer-related arm lymphedema is a serious complication that can adversely affect quality of life. Identifying risk factors that contribute to the development of lymphedema is vital for identifying avenues for prevention. The aim of this study was to examine the association between the development of arm lymphedema and both treatment and personal (e.g., obesity) risk factors
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