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Journal watch - 28/03/13

Rapid Improvement of Diabetes After Gastric Bypass Surgery: Is It the Diet or Surgery?

There is some debate over whether the improvement seen in patients’ type 2 diabetes following gastric bypass is caused by the surgery itself, or by the drastic reduction in calorie intake before and after the operation. This two-stage study first put diabetic patients on a calorie-controlled diet, before giving them a Roux-en-Y gastric bypass, measuring their metabolic factors throughout. It found that the patients’ glucose homeostasis improved in both phases, with a greater effect found before surgery compared to after. This led the researchers to suggest that the diet, rather than the surgery, has the greater effect on the rapid diabetic improvement usually seen after surgery. (Full text)

Reduction in obesity-related comorbidities: is gastric bypass better than sleeve gastrectomy?

Which is better at resolving comorbidites: gastric bypass or sleeve gastrectomy? This study compared a total of 558 patients who underwent one of the two operations, and found that while the procedures had a roughly equal effect on sleep apnea, hyperlipidemia, hypertension, diabetes, and musculoskeletal disease, gastric bypass was more effective at resolving gastro-oesophageal reflux disease. (Full text)

Alcohol consumption and alcohol problems after bariatric surgery in the Swedish Obese Subjects (SOS) study.

The latest results from the Swedish Obese Subjects study look at the rate of alcohol intake among bariatric surgery patients. In line with previous studies, it found that gastric bypass and, to a lesser extent, vertical banded gastroplasty patients were at increased risk of being diagnosed with alcohol abuse, while gastric band patients did not face an increased risk, compared to controls. (Full text)

Gastric pouch reduction using StomaphyX&0153; in post Roux-en-Y gastric bypass patients does not result in sustained weight loss: a retrospective analysis.

The StomaphyX is an endoscopic device which aims to reduce the size of a gastric pouch after a failed gastric bypass. However, this study found that there was no sustained reduction in gastric pouch size 18 months after the device was used, and that the gastric pouch and stoma tended to return to their preprocedure size. The researchers said that it “cannot be recommended” as a weight-loss strategy after an unsatisfactory gastric bypass. (Full text)