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Bariatric Surgery Outcomes in Patients with Latent Autoimmune Diabetes of the Adult

Authors
  • Guimarães, Marta
  • Pereira, Sofia S.
  • Nora, Mário
  • Monteiro, Mariana P.
Type
Published Article
Journal
Obesity Facts
Publisher
S. Karger AG
Publication Date
Jul 28, 2021
Volume
14
Issue
4
Pages
425–430
Identifiers
DOI: 10.1159/000517588
PMID: 34320499
Source
Karger
Keywords
Disciplines
  • Case Report
License
Green
External links

Abstract

Bariatric surgery is a very effective treatment for obesity-associated type 2 diabetes. However, the benefits of bariatric surgery in patients with obesity and autoimmune diabetes, such as type 1 diabetes and latent autoimmune diabetes in adults (LADA), are controversial. We report 3 female patients with obesity and LADA who underwent laparoscopic Roux-en-Y gastric bypass >10 years ago. The patients were diagnosed with LADA both 1 and 9 years before (n = 2) or 11 years after the surgery (n = 1). Patients preoperative body mass index ranged from 36 to 47 kg/m<sup>2</sup> and improved to 23–37 kg/m<sup>2</sup> in the last follow-up visit, 10–15 years after surgery. Daily insulin dose also decreased from an average of 0.68 to 0.45 IU/kg in those patients treated with insulin before bariatric surgery. Only one patient developed diabetes-related target organ damage. This study shows that patients with LADA depict remarkable reduction of body weight and insulin requirements over long-term after bariatric surgery. So, LADA should not be considered a contraindication for bariatric surgery yet should only be recommended for patients with concomitant obesity with the primary aim of achieving sustained weight loss.

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