Type 2 diabetes and bariatric surgery

It all started with patient HK’s legal action against her primary care trust three years ago.

HK, a 40 year old woman, had gastric banding surgery in 2000 when she weighed 111 kg, which led to a weight loss of 49 kg. The band subsequently had to be removed because of complications. She wanted the primary care trust to allow her to have gastric bypass surgery when her weight rose to 100 kg after removal of the band.1 The trust denied her request, stating that although her body mass index (BMI) was 37.8 kg/m² and she had obesity related comorbidities such as glucose intolerance, she fell short of the trust’s local guideline of offering gastric bypass surgery only to patients with a BMI ≥50 kg/m².

In January 2011, after a legal challenge, the primary care trust agreed for her to proceed with surgery. It was carried out at University College