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Type 2 diabetes with severe obesity — SCE Endocrinology MCQ

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ModerateDiabetesType 2 diabetes with severe obesitySCE Endocrinology

A 57-year-old woman with type 2 diabetes has HbA1c 84 mmol/mol, BMI 42 kg/m2 and obstructive sleep apnoea. She has tried intensive lifestyle and pharmacotherapy without durable weight loss. What is the most appropriate management to discuss?

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Correct answer: E — Referral for bariatric surgery assessment

Bariatric surgery assessment is appropriate in severe obesity with type 2 diabetes when conservative measures have not achieved adequate control. Gliclazide and pioglitazone may worsen weight. Normal thyroid tests should not be treated as a weight-loss strategy.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal-nutritional-and-metabolic-conditions