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 #x3e;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.
Obes Facts

中文翻译：

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成人隐匿性自身免疫性糖尿病患者的减肥手术结果

减肥手术是治疗肥胖相关 2 型糖尿病的一种非常有效的方法。然而，减肥手术对肥胖和自身免疫性糖尿病患者（如 1 型糖尿病和成人潜伏性自身免疫性糖尿病 (LADA)）的益处存在争议。我们报告了 3 名患有肥胖症和 LADA 的女性患者，她们在 10 年前接受了腹腔镜 Roux-en-Y 胃旁路术 #x3e。患者在手术前 1 年和 9 年（n = 2）或手术后 11 年（n = 1）被诊断为 LADA 。患者术前体重指数范围为 36 至 47 kg/m ²并改善至 23-37 kg/m ²在最后一次随访中，手术后 10-15 年。在减肥手术前接受胰岛素治疗的患者中，每日胰岛素剂量也从平均 0.68 IU/kg 降至 0.45 IU/kg。只有一名患者出现了与糖尿病相关的靶器官损伤。该研究表明，LADA 患者在减肥手术后的长期体重和胰岛素需求显着降低。因此，LADA 不应被视为减肥手术的禁忌症，而应仅推荐用于以实现持续减肥为主要目的的伴随肥胖的患者。
肥胖事实