Endocrine Abstracts

Background: An increasingly recognized complication of Roux-en-Y Gastric Bypass (RYGB) surgery is the development of postprandial hypoglycaemia (PPH). However, there remains no agreed standard on how to diagnose this condition. Commonly used tests include a prolonged oral glucose tolerance test (POGTT) and mixed meal tolerance test (MMTT). Little is known regarding how these tests compare in the post-bariatric population.Methods: Ten patients who had con...

Introduction: Morbid obesity has serious associated co morbidities and is an independent risk factor for ischaemic heart disease. Obesity together with low functional status and exercise tolerance makes pre-operative cardiac assessment difficult and patients with few cardiac risk factors are often referred for cardiac assessment. This can not only be burdensome to services and prolongs waiting times for surgery but can also cause patient anxiety and poor compliance.<p clas...

Introduction: Improvement in glycaemia is observed early after Roux-en-Y Gastric Bypass surgery (RYGB) in patients with diabetes. Commonly cited mechanisms to account for these changes include the elevation of gut hormones, increase in bile acids levels, changes in the gut microbiota and calorie restriction. Calorie restriction is believed to play a role in improving hepatic insulin sensitivity and reduce hepatic glucose output early after RYGB, in the context of non-significa...

Introduction: Our institution leads a UK, multicentre, randomised controlled trial (REVISE-Diabesity ISRCTN00151053) investigating the interaction of Endobarrier therapy, a 60 cm endoscopically implanted proximal intestinal liner, with glucagon-like peptide-1 drug therapy.Aims: To evaluate whether acquired experience could translate into establishment of an effective and safe NHS Endobarrier service in patients with diabesity.Metho...

Background: Gastric reduction duodenal switch involves restrictive and mal-absorptive aspect, removing approximately 70% of stomach and most of the duodenum. Surgical alteration leading to malabsorption of macronutrients is achieved with varying results of weight loss but resulting nutritional side effects are under-recognised. Issues in nutritional complication leading to neurological complications like peripheral neuropathy are increasingly recognised. We discuss a case of s...

Case history: A 26 year old female with severe gastro-oesophageal reflux disease was seen in our service for assessment prior to roux-en-Y gastric bypass (RYGB) surgery for this condition. She had additional history of obesity, hypertension, insomnia, cholecystectomy for gallstones and anxiety-depression. At age 18 her weight was 85 kg, BMI 28 kg/m2. She gained 40 kg over the subsequent 8 years and in clinic was 123 kg, BMI 41.1 kg/m2 with a gynaecoid pat...

Background: The number of women seeking bariatric surgery in order to improve their fertility is increasing. Current guidelines recommend that pregnancy should be delayed for at least 1 year post-surgery. However, there are limited data regarding pregnancy outcomes post-surgery, particularly for sleeve gastrectomy.Methods: We performed a single-centre, retrospective cohort study of pregnancies in women post-bariatric surgery. Surgical and maternity recor...

Case History: A 55 year old woman with a BMI of 57.4 was referred to our service to assess her suitability for bariatric surgery given her psychiatric surgery. Her problems with weight began aged 8 when she was sexually abused. She saw a doctor aged 14 who prescribed amphetamines for her weight, and states her problems with drugs as an adult (LSD, cannabis, amphetamines) stemmed from this. She has a diagnosis of EUPD-borderline type, and was prescribed quetiapine which had kep...