scholarly journals Duodenal bypass does not decrease glucose levels of lean individuals with gastric cancer submitted to partial or total gastrectomy

2009 ◽  
Vol 46 (3) ◽  
pp. 230-232 ◽  
Author(s):  
Fernando A. Herbella ◽  
Ana C. Tineli ◽  
Jorge L. Wilson Jr ◽  
Jose C. Del Grande
Keyword(s):  
Gastric Cancer ◽  
Glucose Metabolism ◽  
Total Gastrectomy ◽  
Partial Gastrectomy ◽  
Diabetes Control ◽  
Oral Medication ◽  
Diabetic Patients ◽  
Glucose Levels

Change in glucose metabolism after bariatric operations may be credited to duodenal bypass. This study aims to evaluate the effect of duodenal bypass on glucose levels in lean individuals submitted to gastrectomy for gastric cancer. We reviewed 56 non-diabetic and 6 diabetic patients submitted to gastrectomy and Roux-en-Y for gastric cancer (partial gastrectomy in 66%/total gastrectomy in 34%). Glucose levels were not significantly altered after operation (P = 0.5). Diabetes control was improved in one patient with oral medication. In conclusion, duodenal bypass do not decrease glucose levels in lean individuals treated for gastric cancer.

scholarly journals Time Interval After Various Types of Gastrectomy Until Metachronous Multiple Gastric Cancer: Analysis of Data From A Nationwide Japanese Survey

2021 ◽  
Author(s):  
Koshi Kumagai ◽  
Sang-Woong Lee ◽  
Masaichi Ohira ◽  
Masaki Aizawa ◽  
Satoshi Kamiya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Partial Gastrectomy ◽  
Remnant Stomach ◽  
Time Interval ◽  
Reconstruction Procedure ◽  
Initial Surgery ◽  
Number Of Patients ◽  
Multiple Gastric Cancer

Abstract Background The time interval between initial partial gastrectomy and diagnosis of cancer in the remnant stomach reportedly differs according to the reconstruction procedure used in the initial gastrectomy. However, factors correlated with the time interval from the initial surgery for gastric cancer to the detection of metachronous multiple gastric cancer (MMGC) remain unclear. This study was performed to evaluate the association between the type of initial gastrectomy or reconstruction procedure and the time interval from initial gastrectomy to detection of MMGC as well as the association between the type of initial gastrectomy and the procedure performed for MMGC. Methods A questionnaire survey on remnant stomach cancer was conducted by the Japanese Society for Gastro-Surgical Pathophysiology in 2018. Participating facilities were asked to indicate the number of patients who underwent surgery for MMGC between 2003 and 2017, in accordance with the time interval from the initial gastrectomy until treatment for MMGC by type of initial gastrectomy or reconstruction procedure. The number of patients who underwent each treatment procedure (completion total gastrectomy or partial gastrectomy) was also collected. Results Analyses were performed using data from 45 facilities. Gastrectomy for MMGC was performed in 1,234 patients during the period. Billroth-II and Roux-en Y accounted for 22.3% (103/462) and 1.3% (6/462), respectively, of patients who underwent surgery for MMGC ≥ 10 years from initial DG, while these patients accounted for 8.0% (23/286) and 21.7% (65/286), respectively, of patients who underwent surgery for MMGC within 5 years after initial DG. Likewise, the proportion of each reconstruction procedure differed by the time interval from initial proximal gastrectomy to treatment for MMGC. In terms of the treatments performed for MMGC, the proportion of patients who underwent partial gastrectomy increased in accordance with the size of the remnant stomach after the initial gastrectomy. Conclusions The types of gastrectomy or reconstruction procedures for initial gastrectomy differed significantly by time interval between the initial gastrectomy and treatment for MMGC, and their time trends were assumed to be a major cause of the differences. The proportion of patients who underwent completion total gastrectomy deceased as the size of the remnant stomach increased.

scholarly journals The Type of Gastrectomy and Modified Frailty Index as Useful Predictive Indicators for One-Year Readmission Due to Nutritional Difficulty in Patients Who Undergo Gastrectomy for Gastric Cancer.

2021 ◽  
Author(s):  
Tomohiro Osaki ◽  
Hiroaki Saito ◽  
Wataru Miyauchi ◽  
Yuji Shishido ◽  
Kozo Miyatani ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Readmission Rate ◽  
Frailty Index ◽  
Partial Gastrectomy ◽  
Readmission Rates ◽  
Modified Frailty Index ◽  
One Year ◽  
Distal Partial Gastrectomy ◽  
Predictive Indicators

Abstract Background Patients who undergo gastrectomy for gastric cancer are likely to have nutritional difficulty after surgery. Therefore, readmission due to nutritional difficulty is frequently observed in such patients. This study aimed to identify predictive indicators for readmission due to nutritional difficulty in patients who underwent gastrectomy for gastric cancer. Methods We retrospectively reviewed surgical outcomes in 516 consecutive patients who underwent gastrectomy for gastric cancer. Results The readmission rate within one year was 13.8%. Readmission due to nutritional difficulty was observed in 20 patients (3.9%), and nutritional difficulty was the second leading cause of readmission. Multivariate analysis revealed that the type of gastrectomy and the modified frailty index were independent predictive indicators of readmission due to nutritional difficulty. The readmission rates due to nutritional difficulty were 1.2%, 4.7%, and 11.5% in patients who underwent distal partial gastrectomy and had low modified frailty index, in those who underwent distal partial gastrectomy and had high modified frailty index or those who underwent either proximal partial or total gastrectomy and had low modified frailty index, and in those who underwent either proximal partial or total gastrectomy and had high modified frailty index, respectively (P = 0.0008). Conclusions Because the readmission rate due to nutritional difficulty is high in patients who underwent either total or proximal partial gastrectomy with high modified frailty index, intensive follow-up and nutritional support is needed to reduce readmission due to nutritional difficulty, which can help improve the patients’ quality of life and reduce additional medical costs.

scholarly journals Thyroid Disorders and Diabetes Mellitus: Prevalence and Assosciation

2021 ◽  
pp. 220-228
Author(s):  
Mai Hassan Hafez Ahmed ◽  
Rasha Mohammed Abd Elmageed Mohammed
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Thyroid Hormones ◽  
Thyroid Dysfunction ◽  
Diabetes Management ◽  
Endocrine System ◽  
The Body ◽  
Diabetic Patients ◽  
Thyroid Disorders ◽  
Glucose Levels

Background: Diabetes mellitus and thyroid dysfunction are closely related. Numerous studies have reported an increased prevalence of thyroid disorders in diabetic patients, especially in type 1 diabetes mellitus. Objectives: Therefore, the purpose of this review is to discuss the numerous underlying mechanisms behind the relationship between diabetes mellitus and thyroid dysfunction in order to demonstrate that the correlation between these two prevalent conditions is unlikely to be a coincidental finding. Review: Diabetes and Thyroid disorders are characterized by endocrine system dysfunction. Thyroid hormones influence glucose metabolism in different ways, for example, they increase absorption of glucose from the gut, increase GLUT-2 level, regulate energy balance, and cause increased lipolysis which ultimately raises glucose levels in the body. Furthermore, thyroid hormones interact with adiponectin, leptin, ghrelin, to affect glucose metabolism. Additionally, studies suggest that hyperthyroidism impairs diabetic glycemic control, whereas hypothyroidism increases the risk of hypoglycemia, further complicating diabetes management. Conclusion: This paper emphasizes thyroid abnormalities, if left untreated, can raise the risk of several diabetes complications including retinopathy, neuropathy, and nephropathy, and can worsen diabetic symptoms. As a result, treating subclinical hypothyroidism or hypothyroidism in diabetic individuals can be advantageous. Therefore, a systematic method for early thyroid testing in diabetic patients to avoid severe complications is highly recommended.

scholarly journals Type 2 diabetes, obesity, and sex difference affect the fate of glucose in the human heart

2015 ◽  
Vol 308 (12) ◽  
pp. H1510-H1516 ◽  
Author(s):  
Linda R. Peterson ◽  
Pilar Herrero ◽  
Andrew R. Coggan ◽  
Zulia Kisrieva-Ware ◽  
Ibrahim Saeed ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Metabolism ◽  
Glucose Uptake ◽  
Sex Difference ◽  
Plasma Glucose ◽  
Glucose Oxidation ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Glycogen Deposition

Type 2 diabetes, obesity, and sex difference affect myocardial glucose uptake and utilization. However, their effect on the intramyocellular fate of glucose in humans has been unknown. How the heart uses glucose is important, because it affects energy production and oxygen efficiency, which in turn affect heart function and adaptability. We hypothesized that type 2 diabetes, sex difference, and obesity affect myocardial glucose oxidation, glycolysis, and glycogen production. In a first-in-human study, we measured intramyocardiocellular glucose metabolism from time-activity curves generated from previously obtained positron emission tomography scans of 110 subjects in 3 groups: nonobese, obese, and diabetes. Group and sex difference interacted in the prediction of all glucose uptake, utilization, and metabolism rates. Group independently predicted fractional glucose uptake and its components: glycolysis, glycogen deposition, and glucose oxidation rates. Sex difference predicted glycolysis rates. However, there were fewer differences in glucose metabolism between diabetic patients and others when plasma glucose levels were included in the modeling. The potentially detrimental effects of obesity and diabetes on myocardial glucose metabolism are more pronounced in men than women. This sex difference dimorphism needs to be taken into account in the design, trials, and application of metabolic modulator therapy. Slightly higher plasma glucose levels improve depressed glucose oxidation and glycogen deposition rates in diabetic patients.

Nutritional Interventions and Considerations for the Development of Low Calorie or Sugar Free Foods

2020 ◽  
Vol 16 (4) ◽  
pp. 301-312 ◽  
Author(s):  
Jyoti Singh ◽  
Prasad Rasane ◽  
Sawinder Kaur ◽  
Vikas Kumar ◽  
Kajal Dhawan ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Blood Glucose ◽  
Human Population ◽  
Artificial Sweeteners ◽  
Diabetic Patients ◽  
Nutritional Interventions ◽  
Low Calorie ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Diet Plan

Diabetes is a globally prevalent chronic metabolic disease characterized by blood glucose levels higher than the normal levels. Sugar, a common constituent of diet, is also a major factor often responsible for elevating the glucose level in diabetic patients. However, diabetic patients are more prone to eat sweets amongst the human population. Therefore, we find a popular consumption of zero or low-calorie sweeteners, both natural and artificial. But, the uses of these sweeteners have proved to be controversial. Thus, the purpose of this review was to critically analyze and highlight the considerations needed for the development of sugar-free or low-calorie products for diabetic patients. For this purpose, various measures are taken such as avoiding sugary foods, using natural nectar, artificial sweeteners, etc. It cannot be ignored that many health hazards are associated with the overconsumption of artificial sweeteners only. These sweeteners are high-risk compounds and a properly balanced consideration needs to be given while making a diet plan for diabetic patients.

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

2020 ◽  
Author(s):  
Swati Anand ◽  
Amardeep Kalsi ◽  
Jonathan Figueroa ◽  
Parag Mehta
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Positive Impact ◽  
The United States ◽  
Phone Call ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Glucose Levels ◽  
Uncontrolled Diabetes ◽  
Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

The cost-effectiveness of insulin analogs and regular insulin for diabetes control: a case study in Iran

2020 ◽  
Vol 33 (4/5) ◽  
pp. 323-331
Author(s):  
Mohsen pakdaman ◽  
Raheleh akbari ◽  
Hamid reza Dehghan ◽  
Asra Asgharzadeh ◽  
Mahdieh Namayandeh
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Regular Insulin ◽  
Diabetes Control ◽  
Diabetic Patients ◽  
Insulin Analogs ◽  
Content Type ◽  
Patients With Diabetes ◽  
The Government ◽  
The Cost

PurposeFor years, traditional techniques have been used for diabetes treatment. There are two major types of insulin: insulin analogs and regular insulin. Insulin analogs are similar to regular insulin and lead to changes in pharmacokinetic and pharmacodynamic properties. The purpose of the present research was to determine the cost-effectiveness of insulin analogs versus regular insulin for diabetes control in Yazd Diabetes Center in 2017.Design/methodology/approachIn this descriptive–analytical research, the cost-effectiveness index was used to compare insulin analogs and regular insulin (pen/vial) for treatment of diabetes. Data were analyzed in the TreeAge Software and a decision tree was constructed. A 10% discount rate was used for ICER sensitivity analysis. Cost-effectiveness was examined from a provider's perspective.FindingsQALY was calculated to be 0.2 for diabetic patients using insulin analogs and 0.05 for those using regular insulin. The average cost was $3.228 for analog users and $1.826 for regular insulin users. An ICER of $0.093506/QALY was obtained. The present findings suggest that insulin analogs are more cost-effective than regular insulin.Originality/valueThis study was conducted using a cost-effectiveness analysis to evaluate insulin analogs versus regular insulin in controlling diabetes. The results of study are helpful to the government to allocate more resources to apply the cost-effective method of the treatment and to protect patients with diabetes from the high cost of treatment.

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