But "discussing bariatric surgery with your type 1 diabetes patient" is a little more complicated, she said. However, it's relevant. In their work, the group aimed to compare outcomes after bariatric surgery versus medical care in type 1 diabetes based on data from the National Diabetes Register in Sweden and Scandinavian Obesity Surgery SoS registry. They identified patients in Sweden with type 1 diabetes who underwent Roux-en-Y gastric bypass in and matched them with controls with type 1 diabetes of the same gender who did not undergo surgery and had a similar age, diabetes duration, and body mass index BMI.
The primary outcomes were all-cause mortality, cardiovascular mortality, cardiovascular disease, and hypo- or hyperglycemic events that required hospitalization. The mean follow-up was 4. However, the risk of cardiovascular death during follow-up was significantly lower in the patients who had undergone bariatric surgery HR, 0.
Moreover, during the almost 5-year follow-up, those who had bariatric surgery had a much lower risk of heart failure HR, 0. There was a numerical but nonsignificant increase in serious hypoglycemic events in the surgery group. However, patients who had bariatric surgery had twice the risk of a serious hyperglycemic event including DKA that required hospitalization HR, 1. And, she noted, there are further questions, such as, "How do the patients sustain weight loss?
Do they regain the weight?
How does [Roux-en-Y gastric bypass] compare with medical treatment very low-calorie treatment or with gastric sleeve? And in reply to a question from the audience, she said the indication for bariatric surgery in type 1 diabetes is based on BMI alone and not on additional indications that apply in type 2 diabetes such as sleep apnea or complications of type 2 diabetes.
Finally, treatment with GLP-1 receptor agonists and other newer diabetes drugs was not common when the study was conducted, so further research is needed to compare outcomes after bariatric surgery versus medical therapy with these newer agents. For more diabetes and endocrinology news, follow us on Twitter and Facebook. Send comments and news tips to news medscape.
What investigations must be performed prior to surgery?
Freelance writer, Medscape and Heartwire Disclosure: Marlene Busko has disclosed no relevant financial relationships. You've successfully added to your alerts. You will receive email when new content is published. Specialty: Multispecialty. Log In. Sign Up It's Free! Register Log In. No Results. If you log out, you will be required to enter your username and password the next time you visit. This tape is called "steri-strips" and should fall off on its own.
If surgical staples were used, they will have to be removed, usually around the tenth day after surgery. This should not cause any pain.
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No matter how your wound was closed, it is important to keep it clean and dry to promote faster healing. Unless otherwise prescribed, you should shower, wash with soap, rinse and dry thoroughly. If the wound is oozing or catching on clothing, you may cover it with a very light dressing, but otherwise leaving the wound open to air whenever possible may help prevent suture infection. After about three weeks, it is usually safe for your incision to get completely wet. Ask your surgeon for the official "go ahead" before taking a bath.
As you feel stronger, you may enjoy a swim or a soak in the tub.
Despite the greatest care, any wound can become infected. These may be signs of an infection. Do not use any antibiotic ointment or other occlusive ointment on your incision, unless your medical team has instructed you to do so. We do not expect you to have any serious problems after surgery.
Guide to types of weight-loss surgery
However, if you experience any of the symptoms below, you must contact your surgeon right away. Nausea may be related to insufficient chewing, fullness, sensitivity to odors, pain medication, not eating, post-nasal drip or dehydration. In the first days after surgery, nausea usually can be treated with medications called antiemetics. It is very important to take your nausea medication as prescribed by your surgeon.
Rarely, nausea can be so severe that it prevents patients from drinking adequate amounts of liquids. If this happens, you will need to come back to the hospital to receive intravenous IV fluids. Persistent vomiting may lead to dehydration and electrolyte imbalance, which may cause vitamin deficiencies. Odors can sometimes be overwhelming after surgery. If you are dry heaving, try sniffing a few drops of peppermint essential oil on a handkerchief.
Avoid perfumes and scented lotions. If food odors bother you, try having someone else prepare your meals or prepare bland foods. Learn to recognize when you are full. This will not happen immediately, but by eating very slowly, it will become easier. Should you have difficulty drinking due to nausea, try peppermint tea, fennel tea, decaffeinated green tea, or hot or cold water with lemon. Sucking on a cinnamon stick may sometimes help alleviate nausea. If you believe your pain medication is causing nausea, call your surgeon's office to request a prescription change.
Remember to stay hydrated by sipping fluids all day long. You need to drink a minimum of 1.
General FAQs about bariatric surgery
Vomiting is often caused by eating inappropriately. Initially, it can be difficult to gauge how little food will satisfy your hunger — chances are, you will feel full with very little food. A couple of teaspoons may be all you can eat at one time. If you experience prolonged vomiting, stop eating solid foods and sip clear liquids such as clear and very diluted juice, broth and herbal tea.
Should you have difficulty swallowing foods or keeping foods down, please call your surgeon. Vomiting may indicate that your stomach pouch is blocked. If vomiting continues for more than 24 hours, contact your surgeon. Vomiting can lead to severe dehydration, a serious condition that needs medical attention.
Contact your surgeon if you believe you may be dehydrated. Dehydration will occur if you do not drink enough fluids. Symptoms include fatigue, dark colored urine, fainting, nausea, low back pain a constant dull ache across the back and a whitish coating on the tongue. If you experience these symptoms, you will need to have blood work done to establish the severity of dehydration.
Bariatric Surgery Procedures | ASMBS
Dehydration may also lead to bladder and kidney infections. In some cases, you may be admitted to the hospital so we can administer fluids intravenously. It is normal to have one to three bowel movements of soft stool per day. It may be foul smelling and associated with flatulence. Most of these changes resolve as your body heals and you adapt to changes. Please call your surgeon if you have persistent diarrhea. After bariatric surgery, the amount of food you consume is greatly reduced, and the quantity of fiber or roughage you consume may be much smaller.
As a result, the amount of bowel movements you have will be reduced, causing less frequent bowel activity and sometimes constipation.