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Clinical case of a patient with advanced metabolic syndrome following bariatric surgery

Volume 12, Supplement 1

Original Article / Published: April 2024


К. Terzieva, M. Kalinkova

Department of Endocrinology, Acıbadem City Clinic
University Hospital Tokuda, Sofia


Introduction: The escalating prevalence of Type 2 Diabetes Mellitus (T2DM), with its inherent risk of severe complications, underscores the urgency for innovative therapeutic approaches. Although promising therapeutics are in the pipeline, bariatric surgery (also known as metabolic surgery) remains our most effective strategy for the treatment of obesity and type 2 diabetes
mellitus (T2DM). Of the many available options, Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) are currently the most widely used procedures(1)
Clinical case: From 03.23 (photo 1) Anamnesis: A 40-year-old female patient with newly diagnosed type 2 diabetes, obesity grade III, dyslipidaemia, and liver steatosis S3, F3-4 (Metabolic syndrome). Gained 30 kg in the last year, with no effect from weight loss attempts. History of gestational diabetes in 2006. Status: Centripetal accumulation of adipose tissue. Weight 140 kg, BMI 43. Clinical-laboratory investigations: CGM – 7.2- 10.9-10.62-8.58 mmol/l, HbA1c 7.8%; Treatment: Bariatric surgery with mini-gastric bypass laparoscopy and cholecystectomy was performed in March 2023. Follow-up since March 2024 (photo 2): Status: Weight- 82 kg; BMI- 27; Reduction of 58 kg so far. Clinical-laboratory investigations: CGM: 4.12-5.8-3.63-3.78mmol/l; HbA1c 5.1%.
Conclusion: Bariatric surgery is an increasingly adopted approach in the treatment of type 2 diabetes and obesity, leading to short-term complete remission of diabetes and metabolic markers. Moreover, modern bariatric procedures have strong evidence of efficacy and safety. All patients with severe obesity-and especially those with type 2 diabetes-should be informed about the risks and benefits of surgery compared with continuing usual medical and lifestyle treatment, and the decision about surgery should be driven primarily by informed patient preferences (2).


Bariatric surgery, obesity, type 2 diabetes

How to cite this article:

К. Terzieva, M. Kalinkova. Correlation between Clinical case of a patient with advanced metabolic syndrome following bariatric surgery . Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2024; 12(1): 12-13

Corresponding author:

Dr. Maria Kalinkova
UMBAL Tokuda
Department of Internal Medicine
Clinic of Endocrinology and Metabolic Diseases