Dr. Jaydeep Palep: diabetes along with other co-morbidities successfully treated with LSG-DJB

CASE OVERVIEW :

Weight reduction is widely recognized for improving insulin sensitivity in patients with diabetes. A 35 year old patient visited Dr. Jaydeep Palep. He had a history of diabetes and hypertension since 2014, obstructive sleep apnea since 4-5 yrs., and Bronchial asthma for 10 yrs. The patient had 2 spine surgeries and was allergic to NSAIDs. His weight was 113 Kg, with a BMI of 41.01 Kg/m2. He was on Trulicity 1.5 mg SC once a week, Humalog mix 50/50 SC 20-0-14, Montair OD, and Asthalin.

DIAGNOSIS :

His reports on March 3, 2017 revealed fasting blood Sugar of 151 mg/dl and post prandial blood sugar of 262.6 mg/dl. His HbA1c was 8.1 %.

TREATMENT :

The patient was planned for a laparoscopic sleeve gastrectomy with duodenojejunal bypass (LSG-DJB) on April 27, 2017 (150 cm). He was counseled for healthy lifestyle interventions and a diet plan was handed over to the patient. He started with gymming, cycling, and swimming in his physical activity routine. The spine surgery was arranged for him in June 2018.

RESULTS :

Diabetes remission was observed and monthly follow-up showed a continuous improvement in blood parameters. His HbA1c was 5 and his weight was 66.9 kg on a 1-year follow-up. The patient was off from all anti-DM, anti-HTN, anti BA medications, and O2 support. There were no complaints of snoring and sleep was improved. While compliance with diet was good, physical activity was inadequate due to back pain.