Endocrine Abstracts

Bariatric surgery has emerged as an effective tool for people with severe obesity and type 2 diabetes. A 38 years old lady with type 2 diabetes for 10 years and a BMI of 51 kg/m², underwent bariatric surgery (Roux-en-Y gastric bypass). Other past medical history includes hypertension and hyperlipidemia. She was diagnosed with gestational diabetes in her 1^st pregnancy and type 2 diabetes in subsequent pregnancy. She has lifelong problems with her weight. Despite multiple diet clubs in the past and a number of courses for level 2 weight management services, she failed to achieve any significant weight loss. Her glycemic control has been poor with a HbA1c between 75 and 134 mmol/mol despite adherence to healthy diet. She was initially treated with metformin 1 gram bd, liraglutide 1.2 gram od and dapagliflozin 10 mg od. Liraglutide was initially successful with weight loss of about one stone however, her weight increased again. She has been on dapagliflozin, but she cannot tolerate taking it. Then, she was put on novomix 30 insulin 22 units am, 24 units pm. Finally, it came to the decision that bariatric surgery would be the best option for her case. Post-operatively, she has lost a significant amount of body weight (38% since her first appointment) and her glycemic control also showed a significant improvement. She has been off insulin and currently only on metformin 1 gram bd. Her most recent body weight was 96.3 kg and most recent HbA1c was 66 mmol/mmol.