[Clinical case of the month. Natural history of morbid obesity: towards insulin-requiring type 2 diabetes and reversal after bariatric surgery].
Morbid obesity is a crucial risk factor in the development of type 2 diabetes and is often associated with a metabolic syndrome closely linked to insulin resistance. This case report illustrates the natural history of morbid obesity, starting during the adolescence and ending with an extremely severe type 2 diabetes at the age of 40. Numerous attempts of weight loss with various medical approaches failed and diabetes mellitus rapidly became insulin-requiring in a context of extreme insulin resistance. Finally, the patient was submitted to a gastric bypass which resulted in a drastic weight loss over 50 kg during the year following surgery without any significant side-effects or complications. Type 2 diabetes almost disappeared and the classical markers of insulin resistance were markedly improved. This clinical case clearly demonstrates that successful management of obesity with bariatric surgery can reverse severe type 2 diabetes.
De Flines
J
J
Letiexhe
M R
MR
Desaive
C
C
Scheen
A J
AJ
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D015390:Gastric Bypass; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000473:pathology; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss