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Diabetes Management after Bariatric Surgery

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https://www.readbyqxmd.com/read/28707173/intraoperative-ventilation-of-morbidly-obese-patients-guided-by-transpulmonary-pressure
#1
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 (P L) throughout the respiratory cycle...
July 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28689733/long-term-outcome-of-laparoscopic-sleeve-gastrectomy-from-a-single-center-in-mainland-china
#2
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
#3
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)...
June 26, 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
#4
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...
June 11, 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
#5
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
#6
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...
March 27, 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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28365201/pregnancy-after-bariatric-surgery-balancing-risks-and-benefits
#11
REVIEW
Anne-Marie Carreau, Mélanie Nadeau, Simon Marceau, Picard Marceau, S John Weisnagel
The majority of bariatric surgeries in Canada are performed in women of reproductive age. Clinicians encounter more and more often pregnancies that occur after bariatric surgeries. The appropriate management and education of women who want to conceive after bariatric surgery is still unclear due to the lack of consistent data about maternal and neonatal outcomes following bariatric surgery. Maternal obesity during pregnancy confers a higher risk for gestational diabetes, hypertensive disorders, congenital malformations, prematurity and perinatal mortality...
March 29, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28341364/decreased-access-to-bariatric-care-an-analysis-of-referral-practices-to-bariatric-specialists
#12
John A Primomo, Tanyaradzwa Kajese, Garth Davis, Robert Davis, Shinil Shah, Maddie Orsak, Christina Morrison
BACKGROUND: Substantial evidence reveals tolerability and co-morbid disease resolution after bariatric surgery; however, few physicians refer morbidly obese patients for bariatric consultation. OBJECTIVE: To evaluate morbidly obese patient access to bariatric surgical consultation. SETTING: A multidisciplinary, private, bariatric center of excellence. METHODS: Patient surveyed in person regarding preconsultation co-morbidities, physician discussion and support for bariatric surgery, and physician referral practices...
November 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28322429/treatment-challenges-in-type-1-diabetes-after-roux-en-y-gastric-bypass
#13
Lucie Favre, François Pralong, Michel Suter, François R Jornayvaz
Bariatric surgery is an effective treatment of type 2 diabetes in obese patients. The obesity epidemic does not spare patients with type 1 diabetes mellitus (T1DM), but there is no consensus regarding the role of surgery in the management of obese T1DM patients. Published data consistently report significant weight loss after surgery in obese T1DM patients, but long-term glycaemic control remains difficult to achieve. Here we present our experience with a challenging patient and a review of the literature. Our patient successfully underwent a roux-en-Y gastric bypass (RYGB) when she was 28 years old...
March 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28260459/bariatric-surgery-in-renal-transplant-patients
#14
Osama Gheith, Torki Al-Otaibi, Medhat A Halim, Tarek Mahmoud, Ahmed Mosaad, Jude Yagan, Zakaria Zakaria, Suzann Rida, Prasad Nair, Rashad Hassan
OBJECTIVES: The idea of transplanting organs is not new, nor is the disease of obesity. Obese transplant recipients have greater risk of early death than their cohorts, which is not due to increased rejection but due to obesity-related complications, including arterial hypertension, diabetes, and delayed graft function. Here, our aim was to evaluate the effects of bariatric surgery versus lifestyle changes on outcomes of moderate to severely obese renal transplant recipients. MATERIALS AND METHODS: Twenty-two morbidly obese patients with stable graft function who underwent bariatric surgery were compared with 44 obese patients on lifestyle management (control group)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28122320/revisional-bariatric-surgery-in-a-transplant-patient
#15
Salman Al Sabah, Eliana Al Haddad
INTRODUCTION: A BMI of over 35-45kg/m2 is deemed the upper limit for considering a patient for a renal transplant. Voluntary weight loss attempts are a major concern for patients while on hemodialysis, however, bariatric surgeries have opened up a new door to notable weight loss results, even demonstrating significant improvements of patients' diabetic profile and hypertension. CASE REPORT: Case of a 52-year-old male with a BMI of 42 in end-stage renal disease, that needed a kidney transplant but was ineligible to be placed on the waiting list due to his weight...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28065736/long-term-outcomes-of-bariatric-surgery-in-adolescents-with-severe-obesity-fabs-5-a-prospective-follow-up-analysis
#16
Thomas H Inge, Todd M Jenkins, Stavra A Xanthakos, John B Dixon, Stephen R Daniels, Meg H Zeller, Michael A Helmrath
BACKGROUND: Little is known about the long-term outcomes of bariatric surgery for severe adolescent obesity, raising questions about the durability of early responses to surgery. We aimed to analyse long-term (>5 years) outcomes of Roux-en-Y gastric bypass in a cohort of young adults who had undergone the operation during adolescence, in the Follow-up of Adolescent Bariatric Surgery at 5 Plus Years (FABS-5+) extension study. METHODS: A cohort of young people aged 13-21 years underwent Roux-en-Y gastric bypass for clinically severe obesity at a paediatric academic medical centre in the USA...
March 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28017845/endoscopic-sleeve-gastroplasty-significantly-reduces-body-mass-index-and-metabolic-complications-in-obese-patients
#17
Reem Z Sharaiha, Nikhil A Kumta, Monica Saumoy, Amit P Desai, Alex M Sarkisian, Andrea Benevenuto, Amy Tyberg, Rekha Kumar, Leon Igel, Elizabeth C Verna, Robert Schwartz, Christina Frissora, Alpana Shukla, Louis J Aronne, Michel Kahaleh
BACKGROUND & AIMS: Endoscopic sleeve gastroplasty (ESG) is an incisionless, minimally invasive bariatric procedure that reduces the length and width of the gastric cavity to facilitate weight loss. We performed a prospective study to evaluate the effects of ESG on total body weight loss and obesity-related comorbidities. METHODS: We collected data from 91 consecutive patients (mean age, 43.86 ± 11.26 years; 68% female) undergoing ESG from August 2013 through March 2016...
December 23, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28008465/five-year-results-of-laparoscopic-sleeve-gastrectomy-for-the-treatment-of-severe-obesity
#18
David Nocca, Marcelo Loureiro, El Mehdi Skalli, Marius Nedelcu, Audrey Jaussent, Melanie Deloze, Patrick Lefebvre, Jean Michel Fabre
BACKGROUND: Since 2011, the most used bariatric technique in France has been the sleeve gastrectomy. There are still few studies exploring the medium and long-term results of this technique. OBJECTIVE: To describe medium-long-term (5 years) results of a cohort of CHU Montpellier experience in sleeve gastrectomy for morbid obesity. METHODS: All patients that underwent laparoscopic sleeve gastrectomy (LSG) from January 2005 to June 2013 were included in this study...
August 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28008286/pregnancy-after-bariatric-surgery-improving-outcomes-for-mother-and-child
#19
REVIEW
Irene González, Albert Lecube, Miguel Ángel Rubio, Pedro Pablo García-Luna
The significant increase in the prevalence of obesity has led to an increase in the number of obese women who become pregnant. In this setting, in recent years, there has been an exponential rise in the number of bariatric procedures, with approximately half of them performed in women of childbearing age, and a remarkable surge in the number of women who become pregnant after having undergone bariatric surgery (BS). These procedures entail the risk of nutritional deficiencies, and nutrition is a crucial aspect during pregnancy...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/28005136/management-of-pregnancy-in-women-who-have-undergone-bariatric-surgery
#20
REVIEW
Cara Dolin, Akuezunkpa O Ude Welcome, Aaron B Caughey
Importance: As the problem of obesity continues to grow, more patients are choosing to undergo bariatric surgery to lose weight and treat comorbidities, such as diabetes. Of the more than 200,000 procedures performed each year, 80% are in women, many of reproductive age. Taking care of a pregnant woman who has undergone bariatric surgery requires understanding of the risks, the need for additional surveillance, and the limitations of our knowledge about how bariatric surgery affects pregnancy...
December 2016: Obstetrical & Gynecological Survey
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