期刊名称：Annals of Agricultural and Environmental Medicine
印刷版ISSN：1232-1966
电子版ISSN：1898-2263
出版年度：2012
卷号：19
期号：4
页码：798-801
出版社：Institute of Agricultural Medicine in Lublin
摘要：Relationships between abdominal obesity and glucose tolerance disorders have been well documented. There are also many reports concerning body weight gain during insulin therapy. On the other hand, there are reports pertaining to the e ectiveness of surgical treatment of obesity and related type 2 diabetes. The case is presented of a 39-year-old woman with morbid obesity (maximum weight – 141 kg, BMI – 48.8 kg/m2), who reported to the outpatient department for metabolic diseases in December 2009. The patient had su ered from diabetes for 8 years and was treated with insulin – a dose of 114 IU from the day of the rst visit. The patient received education concerning the modi cation of lifestyle, diet and insulin therapy. A balanced diet of 1,200 kcal daily was recommended. The daily insulin dose was reduced to 56 units. The patient was considered as a potential candidate for bariatric surgery. During the preparation for this procedure she was hospitalized in the Diabetology Ward, where the doses of insulin were further reduced and then discontinued. In March 2010, gastric sleeve resec tion was performed. Within 18 months, the patient's body weight was reduced by 66 kg and normalization of glycaemia was obtained, despite the total discontinuation of anti-diabetic drugs. In addition, the remission of psoriatic changes was observed.Conclusions: In patients with type 2 diabetes and severe obesity, in whom a satisfactory metabolic control cannot be achieved with standard hypoglycaemic therapy, further intensi cation of insulin treatment does not have to be the m ethod of choice, although it may lead to the normalization of glycaemia. In some patients there is the possibility of total remission of glucose intolerance due to bariatric surgery, irrespec tive of the previous method of treatment
关键词：obesity; type 2 diabetes; insulin therapy; bariatric surgery
