INS and type 2 diabetes mellitus: Remarkably, patient 1 did not benefit from the expected weight loss after bariatric surgery (<50% EWL) and the metabolic abnormalities (hypertension, dyslipidemia, and insulin-requiring type 2 diabetes) remained, despite an important caloric restriction induced by the sleeve gastrectomy, showing that her metabolic phenotype was not only due to an environmental Western lifestyle.