Summaries of New Discoveries in WLS

Hello Fellows,

Every year the Society of American Gastointestinal and Endoscopic Surgeons has a conference and puts summaries (abstracts) of member surgeons research and presentations on line. Some people, like me find those interesting. This year's abstracts are in the following .pdf file. The bariatric surgery related ones are from p. 80-107.

http://www.sages.org/07program/SAGES_2007_Abstracts_Only.pdf

It's interesting to see what is being attempted. I noticed for example, one surgeon or group of surgeons is succeeding at plugging eroded stomas with a device, others are examining what seems to predispose certain WLS patients to ulcers. There's a real variety.

Here's the SAGES 2007 page in case the link above doesn't work: http://www.sages.org/07program/

Hope You Find Them Interesting,

Dave

Hi Dave, Thanks for the info and link to the pdf document (it worked perfectly for me). I usually find this sort of thing interesting and am unfamiliar with the SAGES site, so it's good to have a new bookmark to check on now and then. (For some reason, I am almost addicted to pdfs; I find the technology and idea of universal, original formatted documents intriguing. So this is a double treat--appealing content and form.) Hope your day is a good one.

Hi Doug,

Glad you're interested in both content and format. As far as I'm aware, no other organization has as many bariatric surgery related presentations as SAGES, so it should be a good one.

.pdf's are neat. I've never tried it, but I think you can even get the software to actually make your own nowadays for free. It used to be several hundred bucks.

Thanks, always for your positivity, energy and great attitude!

Dave

Dave - Thanks for the link... I found a few things interesting... As a type 2 diabetic, it's nice to know there are some surgeons that are investigating the 'phenomenons' associated with WLS and Diabetes, and intestestingly enough, lol, they coincide with my own observances... Like the weight loss overall not being as high as for non-diabetics, even though there definitely is a significant amount of loss compared to nonWLS... And the "novel approach" to the hypoglycemic patient was also quite interesting, as I still do find myself spiking/dumping and even going hypo from time to time... It's not usually directly postprandial, but it would be interesting to see what is going on with that... I had suggested to both my surgeon and primary that it would be at the very least interesting to measure my insulin resistance both pre op and post op, but couldn't get either one to take much interest in ordering the labwork it would take to do that... /shrug   Since it all requires lab slips and/or insurance approvals, I guess it couldn't be 100% considered medically necessary... but it would sure be interesting. Anyways, thanks again for the link!!! ....Nick

Hi Nick,

Glad you found those relevant. It seems that a lot more people are reading those this year than when I put the link up last year. Probably the last thing that surgeons want - a bunch of patients reading about everything that is on the cutting edge (or even "fringe") in their field, but I think it's a good thing.

Glucose tolerance? Isn't that where you have to drink a whole glass of glucose syrup? Bet that would throw a post-op into a major dump (!?). They are probably reluctant to give any sugar-related tests when you've seen improvement from the surgery.

Didn't know diabetics lost more slowly after WLS. That's interesting, maybe due to very high insulin resistance? I'm sure a low carb diet combined with insulin could really send the sugar into a nose dive.

Best Regards,

Dave

Actually, I read them last year too :-) I happen to remember looking thru them. Right, the Glucose Tolerance Test is the one where you drink this awful drink that is almost all sugar then they do bloodwork for 6 hours; it'd pretty much kill anyone RNY postop... LapBand, not so sure, should be okay, but RNY... (shudder).  IMHO (or NSHO lol), Type 2 diabetes is one of those things where, it might be in control or in remission, but once a diabetic, always a diabetic. Type 2 is the one where you are still producing insulin; type 1 is where your pancreas gets burned out or stops producing it. I had similar symptoms to dumping syndrome after eating even preop, and still get it post op, but worse if I get 'into' the carbs.. A lowER carb diet seems to work better for me in regards to not having spiking/dumping/crashing (in that order).. It's really funny, because glucose control is better overall almost immediately after WLS even before there's a weight loss, they seem to think that there are some ghrelin (gut hormone) changes immediately after surgery that make things "better" and reduce insulin resistance... but again, it's only preliminary studies that I've seen so far on this.. a lot of surgeons are still saying "don't know why, but it works..". I think a lot of the overall less weight loss might be overall due to the differences in glycemic response between non-diabetics and diabetics; this is of course, not as an expert, but as a patient (and I didn't even stay at a Holiday Inn express last night (not sure if you've managed to see those commercials over there.. :-) ).  Even though my A1C is < 6 and my fasting glucose levels are < 100 (again, over in Asia/Europe, that would be around a 6, they measure a different scale there), I still have a tendency to spike high when I eat carbs, then come down low and go hypo... Nondiabetics generally stay pretty steady around 100 and almost never spike up higher than a certain level (130) for fasting bloodwork, and beyond a certain level even if they drink something really really sugary like that glucose soda (glucola I think they call it). I've found, for me, that I generally have to 'break' the rules a little bit; my surgeon recommends just 3 meals... If I do that, then 4-5 hours after eating, my sugar's way too low. So what I do is to eat breakfast (usually on the way to work, about 8:30), lunch around 12:30, then around 5-5:30  grab something, either some peanuts, or a kashi granola bar (has more protein and fiber, therefore less carbs than many others).. I usually eat dinner late, so that gives me a few hours 'leeway', but "try" to eat a lighter dinner.   At any point in the day, if I start feeling shaky, I'll check my sugar and usually need to grab something to eat, but try to restrict it to the 'minimum necessary' to bring the blood sugar back up and hold me until I would normally eat. If I do end up eating things that are more carby, or if I have to suddenly shift work schedule (I work in IT, so upgrades, system crashes, etc), or if I'm sick,  then I end up spiking/dumping, which will continue until I can get it under control (think of ripples/waves, start higher, then a little lower, then eventually die out, but it can take a while). As a result, I end up eating a few more calories (haven't measured it total), which I think also contributes to less weight loss. Anyways, off my soapbox.... lol... Have a great day, and thanks again for the post - btw, great pic!! :-) ...Nick