Exhibit A

Photo by Wonderlane

Evidence.

Here is the first case report of many, whereby I will post an illustrative case scenario of an actual patient that I have seen recently in the office or hospital,  exemplifying how Bariatric Surgery altered the course of a patient's Diabetes.  

Here's "Exhibit A".

Demographic  46 y/o WF

Start Weight  358 lbs / BMI  55

Date of Surgery  8/2011 Laparoscopic Gastric Bypass

Diabetes Hx  Relatively well controlled, requring numerous PO meds and Insulin.  Glyco upon referral was 7.9, with FBG of 203.  Diabetes meds: Actos 30 QD, Glumetza 1000 BID, Glipizide ER 10 BID, Lantus 80 mg HS.  Near 10 year history of Diabetes as diagnosed and treated.

Current Diabetes Hx (8/2012)  Currently off all DM meds, maintaining euglycemia with diet, lifestyle and maintenance of her weight off after surgery.  Current weight is 258 with a BMI of 39.

Take Home Point  A vivid, but fairly commonplace example of what a Gastric Bypass can do for an "average" patient with significant obesity, profound insulin resistance, and a notable list of necessary antidiabetic meds.  

Even though her Glyco was not initially in the 'panic mode' range, this patient benefitted greatly from the weight loss-related, as well as the purely metabolic effects of surgery.  Speaking with her just last week, she is overjoyed to be off her multiple DM meds, not needing insulin injections, and not having to pay constant attention to her BG's.  She relishes the added benefit of improved quality of life (that 100 # lost affords her), as well as the resolution of her other comorbidities of OSA, HTN, and hypercholesterolemia. 

A future post will be dedicated to detailing the physiologic mechanisms of diabetic improvement resulting from Bariatric Surgery. Our society (ASMBS) is called the American Society for Metabolic and Bariatric Surgery for good reason.