ECE2021 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (82 abstracts)
Outcome of intensive treatment for obesity at our hospital
Bunzo Matsuura 1 , Hidenori Senba 1 , Hironobu Nakaguchi 1 , Sayaka Kanzaki 2 , Masumi Miyazaki 2 , Kyoko Watanabe 2 , Teruki Miyake 2 , Shinya Furukawa 2 & Yoichi Hiasa 2
1Ehime University Graduate School of Medicine, Lifestyle-related Medicine & Endocrinology, Toon, Japan; 2Ehime University Graduate School of Medicine, Gastroenterology & Metabology, Toon, Japan
Since 2006 at our hospital, lifestyle modification, such as diet and exercise, for obese patients has been provided through a team approach with a physician, dietician, nurse, physical therapist and psychologist. From 2016, a surgeon and anesthesiologist were added to the team for metabolic/bariatric surgery. The aims of this study are to clarify the effectiveness and problems of lifestyle modification for short-term intensive management (for 3 months) and long-term management (for over 2 years), and to clarify the characteristics of patients who transferred for surgical treatment. The diet menu is as follows: intake energy is (resting energy expenditure + exercise energy) × 0.9, and nutrients/total energy is 55–60% carbohydrates, 15–20% protein and 20–25% fat. The exercise is performed as follows: regular exercise more than 3 times per week or more than 5000 steps per day, and if possible, more than 10000 steps per day. Until now, 150 obese patients (mean age of 50 years and mean body mass index (BMI) of 36) have received medical management, and the mean BMI significantly decreased by 1.2 over 3 months. Thirty patients (20%) have transferred for surgical treatment. Seventeen patients had diabetes with a BMI of 31–48 and HbA1c 8–9% despite intensive therapy. Five with a BMI of 41–60 had bilateral knee osteoarthritis and required total knee replacement, three with a BMI of 38–51 had severe sleep apnea, and one with a BMI of 44 had infertility. The complete (HbA1c < 6% without diabetic medication) and partial (HbA1c < 6.5% with some medication) remission of diabetes was achieved in 70% and 30%, respectively. Serum C-peptide levels were significant higher in patients with the complete remission of diabetes than that in patients with the partial remission. In conclusion, diabetic patients need a lower BMI for metabolic/bariatric surgery compared with non-diabetic patients, and baseline serum C-peptide level has a major influence on outcome in Japan.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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