J Korean Diabetes.  2011 Mar;12(1):53-59. 10.4093/jkd.2011.12.1.53.

Improvement of Type 2 Diabetes after Bariatric Surgery in a Patient with Severe Obesity

• Shin MS
• Kim JH
• Hwang JY
• Kim EH
• Lee WJ
• Choi YB
• Kim KC
• Park JY

• KMID: 1851905
• DOI: http://doi.org/10.4093/jkd.2011.12.1.53

Abstract

The prevalence of obesity is steadily increasing worldwide and is commonly associated with metabolic diseases including hypertension, hyperlipidemia, and type 2 diabetes as well as increased mortality. Bariatric surgery is an effective treatment modality for patients with severe obesity and type 2 diabetes that are refractory to conventional treatments. We performed bariatric surgery (biliopancreatic diversion with duodenal switch) in a 23-year-old man with severe obesity and uncontrolled type 2 diabetes. Before surgery, the patient experienced continuous weight gain and aggravated glycemic control despite dietary restrictions, exercise, and medications including high dose insulin. After surgery, his weight was reduced by 17 kg and he was able to stop insulin treatment. This case suggests that bariatric surgery is an effective therapeutic option when severe obesity and type 2 diabetes are refractory to usual treatments.

Keyword

Bariatric surgery; Obesity; Type 2 Diabetes Mellitus

MeSH Terms

Bariatric Surgery
Diabetes Mellitus, Type 2
Humans
Hyperlipidemias
Hypertension
Insulin
Metabolic Diseases
Obesity
Prevalence
Weight Gain
Young Adult
Insulin

Figure

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  Fig. 1. Schematic of the biliopancreatic diversion with duodenal switch procedure. Sleeve gastrectomy was performed. The duodenum was divided immediately beyond the pylorus and the alimentary limb was connected to the duodenum while the biliopancreatic limb was connected to the ileum (75 cm) proximal to the ileocecal valve.

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  Fig. 2. Subcutaneous fat (between open arrow and arrow head) and intraperitoneal fat (inside of dot line arrow) was measured by fat computed tomography. (A) Three months prior to operation. (B) Five months after operation.

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