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

Obes Facts. 2021;14(4):425-430. doi: 10.1159/000517588. Epub 2021 Jul 28.

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/m2 and improved to 23-37 kg/m2 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.

Keywords: Bariatric surgery; Latent autoimmune diabetes of adult; Roux-en-Y gastric bypass.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bariatric Surgery*
  • Body Mass Index
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / surgery
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / surgery
  • Female
  • Gastric Bypass*
  • Humans
  • Laparoscopy*
  • Obesity, Morbid* / complications
  • Obesity, Morbid* / surgery
  • Retrospective Studies
  • Treatment Outcome