We thank Middelbeek and Brown (1) for their interest in our work and for their comments on our article (2) about the effects of bariatric surgery in type 1 diabetes. We agree with their view that the metabolic responses to bariatric surgery in severely obese patients with type 1 diabetes are poorly understood. Hence, we thought it was important to publish our data, albeit limited to a retrospective analysis of 10 patients with type 1 diabetes who underwent bariatric surgery at the Cleveland Clinic. They point out that we did not distinguish whether our patients were being treated by continuous subcutaneous insulin infusion (CSII) or multiple …