- Sublimis Argentina offers affordable gastric bypass surgery abroad

A new study shows that although gastric bypass surgery reverses Type 2 diabetes in a large percentage of obese patients, the disease recurs in about 21 percent of them within three to five years. The study results were presented at The Endocrine Society’s 94th Annual Meeting in Houston.

“The recurrence rate was mainly influenced by a longstanding history of Type 2 diabetes before the surgery,” said the study’s lead author, Yessica Ramos, MD, an internal medicine resident at Mayo Clinic Arizona in Scottsdale. “This suggests that early surgical intervention in the obese, diabetic population will improve the durability of remission of Type 2 diabetes.”

Ramos and her co-investigators studied the medical records of 72 obese patients with Type 2 diabetes who underwent a Roux-en-Y gastric bypass operation between 2000 and 2007 and had at least three years of follow-up visits. Of these, 66 patients (92 percent) had a reversal of their diabetes at some point, the authors reported.

- Before and after a Gastric Bypass Surgery

Within three to five years after surgery, however, 14 (21 percent) of the 66 patients experienced a recurrence of their Type 2 diabetes, as documented by bloodwork or restarting use of diabetes medications. The patients who did not have recurrence of diabetes lost more weight initially and maintained a lower mean weight throughout the five years of follow-up, although both groups regained similar amounts of weight. There was no significant association between higher recurrence rate and body mass index before surgery, the authors found.

They did find that the longer the duration of Type 2 diabetes before surgery, the higher the probability of diabetes recurrence. Study patients with more than a five-year duration of Type 2 diabetes before they had bariatric surgery were 3.8 times more likely to have recurrence of type 2 diabetes compared to patients with less than a 5 year history of diabetes.

“Providers and patients need to be aware of this information, to have a better idea of the expected outcome and be able to make an informed decision about pursuing gastric bypass surgery,” Ramos said.

Bariatric Surgery in Diabetic Adults Improves Insulin Sensitivity Better than Diet

San Diego, CA — Gastric bypass surgery improves Type 2 diabetes by other mechanisms in addition to weight loss and does so better than a low-calorie diet despite achieving equal weight loss, a new study finds. The results will be presented Monday at The Endocrine Society’s 92nd Annual Meeting in San Diego.

“Our study shows that in the short term, weight loss by diet alone does not achieve the same improvements in diabetes as gastric bypass surgery,” said the presenting author, Judith Korner, MD, PhD, assistant professor of medicine at Columbia University College of Physicians and Surgeons, New York.

Korner and her colleagues found that gastric bypass surgery better improved insulin sensitivity, the body’s ability to successfully clear glucose sugar from the bloodstream into the cells. Insulin sensitivity is impaired in people with Type 2 diabetes, and obesity adds to this problem. The result is a buildup of sugar in the blood.

The study compared the effects on diabetic adults of a low-calorie diet versus Roux-en-Y gastric bypass, the most common gastric bypass procedure. Roux-en-Y gastric bypass decreases the size of the stomach and reroutes the digestive tract to bypass most of the stomach and part of the small intestine. After gastric bypass, many diabetic patients achieve normal blood glucose control or vastly improved control, and some may no longer require diabetes medications.

In the study, seven obese patients with Type 2 diabetes received a daily 800-calorie liquid diet and no surgery, while seven other obese diabetic adults underwent gastric bypass surgery. The study ended when both groups lost the same amount of weight: an average of 8 percent of body weight. However, the surgery-treated patients lost the weight faster: in about 3.5 weeks compared with 8 weeks for the dieters.

Surgical patients were able to discontinue all of their diabetes medications by the study’s end, but the dieters reduced their medication use by 55 percent, Korner reported.

The researchers found significant improvements in the surgery group in measures of insulin sensitivity and function of beta cells, the insulin-producing cells in the pancreas. Improvements in insulin sensitivity in the low-calorie diet group were not statistically significant and beta cell function improved to a lesser extent.

Korner speculated that hormonal changes may be responsible for the improvements resulting from Roux-en-Y surgery in individuals with Type 2 diabetes.

“It will be important to understand how surgery works to produce these results so that we can develop medical therapies of equivalent efficacy,” she said.

The National Institute of Diabetes and Digestive and Kidney Diseases funded this study.

For information about bariatric surgery abroad please do not hesitate to contact Sublimis Argentina.

Obese women who have bariatric surgery before getting pregnant are at significantly lower risk for developing dangerous hypertensive disorders during pregnancy than those who don’t, according to a study of medical insurance records by Johns Hopkins experts.

Hypertensive disorders in pregnancy — which include gestational hypertension, preeclampsia and eclampsia — complicate an estimated 7 percent of pregnancies in the United States. Researchers say they are much more common in obese women, who make up a third of women of childbearing age.

“We have long known that women who have these blood pressure disorders are not only at an increased risk for pregnancy complications in themselves and their babies, but also for chronic diseases in the future,” says Wendy L. Bennett, M.D., M.P.H., assistant professor of medicine at the Johns Hopkins University School of Medicine and a study leader. “Can we prevent the development of these disorders in pregnancy with bariatric surgery? These findings suggest the answer may be ‘yes.’”

Results of the research are published online in the British Medical Journal.

Before and after bariatric surgery

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Obese Teens Who Receive Gastric Banding Achieve Significant Weight Loss

Chicago — A higher percentage of severely obese adolescents who received laparoscopic adjustable gastric banding lost more than 50 percent of excess weight and experienced greater benefits to health and quality of life compared to those in an intensive lifestyle management program, according to a study in the February 10 issue of JAMA.

Adolescent obesity is a serious health challenge globally. In the U.S., more than 17.4 percent, or more than 5 million adolescents were obese in 2004, an increase from 14.8 percent in 2000. Obesity is associated with both immediate and late health effects and reduced life expectancy, according to background information in the article. Lifestyle programs that have included changes in diet, exercise, and behavior to promote weight loss often have poor results. “Bariatric surgery is now extensively used for adults and is being evaluated for adolescents,” the authors write. “Laparoscopic adjustable gastric banding (gastric banding) has the potential to provide a safe and effective treatment.”

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Model Estimates Risks and Benefits of Bariatric Surgery for Severely Obese

Chicago — A computerized model suggests that most morbidly obese individuals would likely live longer if they had gastric bypass surgery, according to a report in the January issue of Archives of Surgery, one of the JAMA/Archives journals. However, the best decision for individual patients varies based on factors such as age, increasing body mass index and the effectiveness of surgery.

An estimated 5.1 percent of the U.S. population is morbidly obese, often defined as having a body mass index (BMI) of 40 or higher, according to background information in the article. Available evidence suggests that dietary, behavioral and pharmacologic treatments frequently do not result in meaningful weight loss for individuals in this group. Bariatric surgery appears to be the only effective therapy for promoting clinically significant weight loss and improving obesity-related health conditions for the morbidly obese. However, the procedure is not without risk, including in-hospital death.

Daniel P. Schauer, M.D., M.Sc., of the University of Cincinnati Academic Health Center, and colleagues used two nationally representative surveys and a recent large observational trial to construct a model estimating the benefits and risks of gastric bypass surgery for individuals with morbid obesity. The model included data from almost 400,000 individuals nationwide to estimate the risk of death from obesity and its complications; data from 23,281 patients undergoing bariatric surgery to calculate in-hospital death rates following the procedures; and outcomes from participants in a seven-year study to determine the effects of surgery on survival and to calibrate and validate the model.

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Linking weight loss to less sleep apnea

Temple-led study, the largest of its kind, finds weight loss has significant impact on the disorder

More than 12 million people in the U.S. suffer from sleep apnea, most common among the overweight and obese. More than just loud snoring, it can lead to high blood pressure, stroke, cardiovascular disease and a poor quality of life. For years, doctors have told patients with sleep apnea that their best bet for alleviating it would be to lose weight, but there’s been very little research-based evidence to prove that.

“Existing research has been limited by a number of factors, so there are very few studies that show whether the recommended amount of weight loss – about 10 percent – is enough to sufficiently improve sleep apnea,” said Gary Foster, director of the Center for Obesity Research and Education.

Foster and colleagues from six other universities recently completed the largest randomized study on the effects of weight loss on sleep apnea in patients with type 2 diabetes. They found that among patients with severe sleep apnea, those who lost the recommended weight were three times more likely to nearly eliminate the number of sleep apnea episodes compared to those who did not lose weight. The results are published in the Sept. 28 issue of the Archives of Internal Medicine.

The new study, called Sleep AHEAD, looked at 264 obese patients with type 2 diabetes already enrolled in the Look AHEAD trial, an ongoing 16-site study investigating the long-term health impact of an intensive lifestyle intervention in 5,145 overweight or obese adults with type 2 diabetes. Participants were between 45 and 75 years old.

The 264 participants were broken into two randomized groups: the first received a group behavioral weight loss program developed especially for obese patients with type 2 diabetes, portion-controlled diets, and a prescribed exercise regimen of 175 minutes per week. The second attended three group informational sessions over a one-year period that focused on diabetes management through diet, physical activity and social support.

After one year, members of the first group lost an average of 24 pounds. More than three times as many participants in this group had complete remission of their sleep apnea (13.6 percent compared to 3.5 percent), and also had about half the instances of severe sleep apnea as the second group. Further, participants in the second group only lost about a pound, and saw significant worsening of their sleep apnea, which suggested to Foster and his team that without treatment, the disorder can progress rapidly.

“These results show that doctors as well as patients can expect a significant improvement in their sleep apnea with weight loss,” said Foster, the study’s lead author. “And a reduction in sleep apnea has a number of benefits for overall health and well-being.”

For more information about weight loss benefits don’t hesitate to contact us.

Weight loss Before and After Photos: Gastric Bypass

In general defined, gastric bypass surgery describes any bariatric procedure that alters the digestive tract so that certain parts are “bypassed”. The food when passes through this altered tract, the body absorbs from it less calories than usual. The gastric bypass is the operation more commonly used to neutralize obesity.

Here are some photos before and after a gastric bypass surgery. For more information feel free to contact Doctor Norman Jalil.