case_images: PMC7683913_01
case_images: Graph of HbA1c (hemoglobin A1c), FPG (fasting plasma glucose), and BMI (body mass index) measured during 2005 to 2019, 2005 to 2014, and 2007 to 2018, respectively. Actual data points are represented by markers. T2D (type 2 diabetes) was diagnosed in 2005. VSG (vertical sleeve gastrectomy) and RYGB (Roux-en-Y gastric bypass) were performed in 2009 and 2013, respectively.
case_images: 10.1177_2324709620974871-fig1.jpg
case_images: PMC7683913_01_10.1177_2324709620974871-fig1.jpg
case_images: fig1-2324709620974871
case_images: A retrospective evaluation of his clinical data showed that he was first diagnosed with T2D in August 2005 when he was 39 years old (HbA1c = 8.1%; Figure 1). His fasting plasma glucose (FPG) ranged from 6.1 to 6.5 mmol/L over 3 visits within 2005 (Figure 1). The highest recorded body mass index (BMI) of the subject was 43 kg/m2 in January 2007 (Figure 1). HOMA2) was considered normal. After VSG, the oral hypoglycemic agent was stopped within 2 weeks, and his HbA1c (5.1% to 5.9%) and FPG (4.3-5.1 mmol/L) concentrations were maintained within normal ranges, although HbA1c fluctuations were observed (Figure 1). His hemoglobin concentrations decreased to below normal range (reference range = 13-17 g/dL) after surgery, ranging from 11.1 to 12.2 g/dL based on results obtained between July 2009 and June 2011, indicating mild anemia.
case_images: Bidirectional Sanger sequencing of the GCK gene. A nucleotide change from G to T resulted in an amino acid change from arginine to leucine.
case_images: 10.1177_2324709620974871-fig2.jpg
case_images: PMC7683913_01_10.1177_2324709620974871-fig2.jpg
case_images: fig2-2324709620974871
case_images: The variant was confirmed by bidirectional Sanger sequencing (Figure 2).