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Diabetes Management after Bariatric Surgery

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https://www.readbyqxmd.com/read/29748734/selection-of-bypass-vs-sleeve-for-the-management-of-type-2-diabetes-in-severely-obese-could-ethnicity-play-a-role
#1
Aparna Govil Bhasker, John B Dixon, Muffazal Lakdawala
PURPOSE: Prospective data was evaluated to see whether bariatric procedure type made any difference to diabetes remission. METHODS: One hundred eighty-six consecutive patients of Indian ethnicity (M:F 89:97) with type 2 diabetes mellitus (T2DM) and HbA1c > 6.5 were assessed before and at 1 year following surgery. Age, BMI, C-peptide and duration of diabetes (ABCD - described by WJ Lee), insulin use, baseline HbA1c, and % weight loss were tested as modifiers...
May 10, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29598850/evaluation-of-risk-factors-for-complications-after-bariatric-surgery
#2
D Quilliot, M-A Sirveaux, C Nomine-Criqui, T Fouquet, N Reibel, L Brunaud
The decision to perform a bariatric surgical procedure, the conclusion of a clinical pathway in which management is individually adapted to each patient, is taken after multidisciplinary consultation. Paradoxically, the patients who would most benefit from surgery are also those who have the highest operative risk. In practice, predictive factors of mortality and severe postoperative complications (Clavien-Dindo>III) must be used to evaluate the benefit/risk ratio most objectively. The main risk factors are age, male gender, body mass index, obstructive sleep apnea syndrome, insulin resistance and diabetes, tobacco abuse, cardiovascular disease, ability to lose weight before surgery, hypoalbuminemia and functional disability...
March 26, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29547850/malnutrition-secondary-to-gastrojejunal-stricture-after-biliopancreatic-diversion
#3
Belén Pérez-Pevida, Daniela Stefania Trifu, Anna Kamocka, Julia Álvarez Hernández
CONTEXT: Bariatric surgery has beneficial effects on obesity and associated comorbidities such as glycaemic control in type 2 diabetes, dyslipidaemia, hypertension, and renal and hepatic function. Nevertheless, this surgery is not free of complications and possible side effects due to restrictive and/or malabsorptive related components. CASE DESCRIPTION: We report the case of a 60-year-old woman whose past medical history included morbid obesity, hypertension and Scopinaro biliopancreatic diversion (BPD) with duodenal switch in 1998...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29340555/the-role-of-the-sleeve-gastrectomy-and-the-management-of-type-2-diabetes
#4
Taíse Fuchs, Marcelo Loureiro, Gabriela Heloise Both, Heloise Helena Skraba, Thaís Andrade Costa-Casagrande
Currently, bariatric surgery has promoted weight loss and improved glycemic control in obese patients through different techniques, including vertical sleeve gastrectomy. Present and update the different vertical sleeve gastrectomy ways of action, both in the treatment of obesity and diabetes, approaching its potential effect on gastrointestinal physiology, as well as the benefits achieved by this manipulation. Pubmed database search was used crossing the headings: obesity, type 2 diabetes and sleeve gastrectomy...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29151717/bariatric-surgery-a-perspective-for-primary-care
#5
Scott Kizy, Cyrus Jahansouz, Keith Wirth, Sayeed Ikramuddin, Daniel Leslie
IN BRIEF Bariatric surgery is the most efficacious treatment for obesity, type 2 diabetes, and other obesity-related comorbidities. In this article, the authors review the current indications for bariatric surgery and discuss the most commonly performed procedures. They analyze medical outcomes of bariatric procedures by reviewing key prospective trials and discuss changes in physiology after these procedures. They conclude by discussing long-term management of bariatric patients by reviewing current guidelines for nutritional support and listing common complications related to these procedures...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29077514/obesity-in-women-insights-for-the-clinician
#6
Zujaja Tauqeer, Gricelda Gomez, Fatima Cody Stanford
As a leading cause of morbidity and mortality in the United States and worldwide, obesity is a disease that is frequently encountered in clinical practice today and requires a range of medical interventions. While obesity affects both men and women across all ages, multiple issues are particularly germane to women's health, particularly as obesity is more prevalent among women than men in the United States and obesity among women of reproductive health relates to the growing issue of childhood obesity. Discussed herein are the epidemiology and pathophysiology of obesity along with the impact of perinatal obesity on fetal programming...
October 27, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29053203/preoperative-weight-loss-with-glucagon-like-peptide-1-receptor-agonist-treatment-predicts-greater-weight-loss-achieved-by-the-combination-of-medical-weight-management-and-bariatric-surgery-in-patients-with-type-2-diabetes-a-longitudinal-analysis
#7
Tien Tang, Sally Abbott, Carel W le Roux, Violet Wilson, Rishi Singhal, Srikanth Bellary, Abd A Tahrani
We examined the relationship between weight changes after preoperative glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment and weight changes from the start of medical weight management (MWM) until 12 months after bariatric surgery in patients with type 2 diabetes in a retrospective cohort study. A total of 45 patients (64.4% women, median [interquartile range] age 49 [45-60] years) were included. The median (interquartile range) weight loss from start of MWM until 12 months post-surgery was 17...
March 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28958400/the-case-for-stepped-care-for-weight-management-after-bariatric-surgery
#8
Melissa A Kalarchian, Marsha D Marcus
Among carefully screened patients, bariatric surgery has proven safe and efficacious in the management of clinically severe obesity and poorly controlled type 2 diabetes. Nonetheless, individual outcomes vary, suggesting the need for interventions to maximize and sustain the health benefits of surgery. In this short review, we synthesize findings from the extant research literature to suggest the potential utility of a stepped care approach to optimize the postsurgery weight trajectory, which requires further research using adaptive designs...
January 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28956359/metabolic-surgery-in-korea-what-to-consider-before-surgery
#9
REVIEW
Mi Kyung Kim, Yoonseok Heo
Obesity is increasing globally and represents a significant global health problem because it predisposes towards various diseases, such as type 2 diabetes mellitus, cardiovascular disease, degenerative joint disease, and certain types of cancer. Numerous studies have shown that bariatric surgery reduces body mass and ameliorates obesity-related complications, such as hypertension and hyperglycemia, suggesting that surgery is the most effective therapeutic option for severely obese and obese diabetic patients...
September 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28858079/laparoscopic-vertical-sleeve-gastrectomy-a-5-year-veterans-affairs-review
#10
Rahman G Barry, Farzad A Amiri, Todd W Gress, D Blaine Nease, Timothy D Canterbury
The aim of this study was to evaluate the outcomes after laparoscopic sleeve gastrectomy (SG) in a VA population.SG has recently gained popularity as a definitive bariatric surgery procedure. Data are lacking on long-term outcomes, particularly in a Veterans Affairs population.We retrospectively reviewed 223 patients who underwent SG for morbid obesity between January 2009 and June 2014. Data on length of stay, complications, interval weight loss, comorbidities, and number of therapies preoperatively and at long-term follow-up were collected...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28707173/intraoperative-ventilation-of-morbidly-obese-patients-guided-by-transpulmonary-pressure
#11
Lars Eichler, Katarzyna Truskowska, A Dupree, P Busch, Alwin E Goetz, Christian Zöllner
BACKGROUND: Bariatric surgery has proven a successful approach in the treatment of morbid obesity and its concomitant diseases such as diabetes mellitus and arterial hypertension. Aiming for optimal management of this challenging patient cohort, tailored concepts directly guided by individual patient physiology may outperform standardized care. Implying esophageal pressure measurement and electrical impedance tomography-increasingly applied monitoring approaches to individually adjust mechanical ventilation in challenging circumstances like acute respiratory distress syndrome (ARDS) and intraabdominal hypertension-we compared our institutions standard ventilator regimen with an individually adjusted positive end expiratory pressure (PEEP) level aiming for a positive transpulmonary pressure (PL ) throughout the respiratory cycle...
January 2018: Obesity Surgery
https://www.readbyqxmd.com/read/28689733/long-term-outcome-of-laparoscopic-sleeve-gastrectomy-from-a-single-center-in-mainland-china
#12
Pankaj Kumar Hans, Wei Guan, Shibo Lin, Hui Liang
BACKGROUND/OBJECTIVE: Laparoscopic sleeve gastrectomy (LSG) is at present the most popular bariatric procedure due to its significant weight loss, remission of co-morbidities, and acceptable morbidity. But, there are not many studies showing its long term efficacy and safety in Chinese patients. The aim of this study is to give five results of LSG in terms of weight loss, co-morbidity (Type 2 diabetes mellitus) resolution and possible complications from a single center in mainland China...
July 7, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28653181/laparoscopic-sleeve-gastrectomy-for-the-management-of-type-1-diabetes-mellitus
#13
Salman Al Sabah, Eliana Al Haddad, Talal H Muzaffar, Ahmad Almulla
BACKGROUND: The prevalence of obesity is on a continuous rise worldwide, with major studies clearly correlating obesity with the development of chronic metabolic disorders including type 2 diabetes. Bariatric surgery has proven to be beneficial in the management of this condition; however, a limited number of studies exist on its effect on type 1 diabetes. OBJECTIVE: The objective of this study is to evaluate the outcome of laparoscopic sleeve gastrectomy for the management of patients with type 1 diabetes (DM1)...
December 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28601988/surgical-and-advanced-medical-therapy-for-the-treatment-of-type-2-diabetes-in-class-i-obese-patients-a-short-term-outcome
#14
Mohit Bhandari, Winni Mathur, Ravindra Kumar, Arun Mishra, Mahak Bhandari
BACKGROUND: Bariatric surgery, incretin-based therapy (glucagon-like peptide-1 analogues), and sodium-glucose co-transporter 2 (SGLT2) inhibitors have antidiabetic properties in morbidly obese patients. However, their comparative efficacy in treating type 2 diabetes mellitus (T2DM) in class I obese patients specifically in Indian has not been studied yet. This study evaluates and compares the efficacy and side effect of surgical and advanced medical management of T2DM in class I obese patients...
December 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28560633/simultaneous-living-donor-liver-transplant-with-sleeve-gastrectomy-for-metabolic-syndrome-and-nash-related-esld-first-report-from-india
#15
Suneed Kumar, Nidhi Khandelwal, Abhaya Kumar, Kapildev Yadav, Swapnil Sharma, Shailesh Sable, Ashutosh Chauhan, Sorabh Kapoor, Vibha Varma, Jaydeep Palep, Vinay Kumaran
Nonalcoholic steatohepatitis (NASH) with morbid obesity and metabolic syndrome is now a common cause of end-stage liver disease (ESLD). These patients are high-risk candidates for liver transplant, and require bariatric surgery to prevent recurrent disease in the new liver. Data reports bariatric surgery after transplant, which maybe difficult because of adhesions between the stomach and liver in living donor liver transplant (LDLT) recipient. We report the first case of combined LDLT with sleeve gastrectomy (SG) from India...
May 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28526434/a-systematic-review-of-portomesenteric-vein-thrombosis-after-sleeve-gastrectomy
#16
Osama Shaheen, Jacqueline Siejka, Bala Thatigotla, Dang Tuan Pham
BACKGROUND: Portomesenteric vein thrombosis (PMVT) is considered an uncommon complication in general surgery; nevertheless, with the growing popularity of sleeve gastrectomy (SG) as a bariatric procedure we have seen an increase in the occurrence of this complication. OBJECTIVES: To elucidate the question if it is a procedure-related complication and explore the modalities of prevention and treatment of this complication, a systematic review of available literature regarding PMVT events after SG was conducted...
August 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28501321/the-effect-of-close-postoperative-follow-up-on-co-morbidity-improvement-after-bariatric-surgery
#17
Andrea Schwoerer, Kevin Kasten, Adam Celio, Walter Pories, Konstantinos Spaniolas
BACKGROUND: Patients undergoing gastric bypass (RYGB) surgery require follow-up for efficacy assessment, early detection of postoperative complications, and also for management of co-morbid conditions. Recent literature shows support for improved long-term weight loss with close patient follow-up. However, attrition rates after RYGB have been reported as high as 50%. OBJECTIVE: The objective of this study was to assess the relationship between complete follow-up and improvement or remission of co-morbid conditions at 12 months after surgery...
March 28, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28477035/increased-%C3%AE-cell-mass-in-obese-rats-after-gastric-bypass-a-potential-mechanism-for-improving-glycemic-control
#18
Shuping Zhang, Wei Guo, Jinshan Wu, Lilin Gong, Qifu Li, Xiaoqiu Xiao, Jun Zhang, Zhihong Wang
BACKGROUND Over the past few decades, bariatric surgery, especially Roux-en-Y gastric bypass (RYGB), has become widely considered the most effective treatment for morbid obesity. In most cases, it results in enhanced glucose management in patients with obesity and type 2 diabetes (T2D), which is observed before significant weight loss. However, what accounts for this effect remains controversial. To gain insight into the benefits of RYGB in T2D, we investigated changes in the β-cell mass of obese rats following RYGB...
May 6, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28440515/-interpretation-of-the-international-joint-statement-on-metabolic-surgery-in-the-treatment-algorithm-for-type-2-diabetes
#19
Peng Zhang, Chengzhu Zheng
Along with the soaring prevalence of obesity and type 2 diabetes mellitus (T2DM) globally, metabolic and bariatric surgery (MBS) has been rapidly developing into a major surgical subspecialty. However, the indications, benefits and potential risks of MBS are still controversial so far. In September 2015, the 2nd Diabetes Surgery Summit (DSS-II() was successfully convened, and later on an international joint statement on metabolic surgery in the treatment algorithm for T2DM was released based upon the consensus reached in DSS-II(, aiming to serve as a new global clinical guideline...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28390813/bile-acids-and-bariatric-surgery
#20
REVIEW
Vance L Albaugh, Babak Banan, Hana Ajouz, Naji N Abumrad, Charles R Flynn
Bariatric surgery, specifically Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), are the most effective and durable treatments for morbid obesity and potentially a viable treatment for type 2 diabetes (T2D). The resolution rate of T2D following these procedures is between 40 and 80% and far surpasses that achieved by medical management alone. The molecular basis for this improvement is not entirely understood, but has been attributed in part to the altered enterohepatic circulation of bile acids...
August 2017: Molecular Aspects of Medicine
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