No-Light-Beers

25% Drink 16% Calories Via Alcohol Daily.

About 25% of you drink alcohol every day — given the normal non-weight loss surgical population according to a new CDC study.  And about 16% of your daily calories come from alcohol.  

PS.  Give this study to bariatric patients – I would say from my very non-professional standpoint that results would be higher vs. calorie intake given our higher rates of addictions to All The Things.  

That is some scary daily nutrition math.

No-Light-Beers

Cheers.

CDC

Screen Shot 2012-12-07 at 8.16.05 PM

The U.S. population consumes an average of 100 calories a day from alcoholic beverages. Men, 150 calories; women, 53.

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“If you are drinking an extra 150 calories more than you need a day, those extra calories could end up on your waist or your hips,” said Joan Salge Blake, a clinical associate professor in the nutrition program at Boston University and a spokeswoman for the Academy of Nutrition and Dietetics. “Those excess daily calories could cause you to put on a pound monthly and would add up to over 10 pounds in a year,” Blake said.

Specifically for a gastric bypass patient — it can lead to all sorts of damage.  Play in the Google.  

Type 2 Diabetes Finger Stick

Weight Loss Surgery Doesn’t Cure Diabetes, forever – Sorry.

"I had weight loss surgery and beat diabetes, FOREVER!"  Not so much.

Don't buy that tee shirt just yet.

Type 2 Diabetes Finger Stick

NYT

Many people whose diabetes at first went away were likely to have it return. While weight regain is a common problem among those who undergo bariatric surgery, regaining lost weight did not appear to be the cause of diabetes relapse. Instead, the study found that people whose diabetes was most severe or in its later stages when they had surgery were more likely to have a relapse, regardless of whether they regained weight.

“Some people are under the impression that you have surgery and you’re cured,” said Dr. Vivian Fonseca, the president for medicine and science for the American Diabetes Association, who was not involved in the study. “There have been a lot of claims about how wonderful surgery is for diabetes, and I think this offers a more realistic picture.”

The findings suggest that weight loss surgery may be most effective for treating diabetes in those whose disease is not very advanced. “What we’re learning is that not all diabetic patients do as well as others,” said Dr. David E. Arterburn, the lead author of the study and an associate investigator at the Group Health Research Institute in Seattle. “Those who are early in diabetes seem to do the best, which makes a case for potentially earlier intervention.”

Obes Surg. 2012 Nov 18. [Epub ahead of print]

A Multisite Study of Long-term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass.

Source

Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA, arterburn.d@ghc.org.

Abstract

BACKGROUND:

Gastric bypass has profound effects on glycemic control in adults with type 2 diabetes mellitus. The goal of this study was to examine the long-term rates and clinical predictors of diabetes remission and relapse among patients undergoing gastric bypass.

METHODS:

We conducted a retrospective cohort study of adults with uncontrolled or medication-controlled type 2 diabetes who underwent gastric bypass from 1995 to 2008 in three integrated health care delivery systems in the USA. Remission and relapse events were defined by diabetes medication use and clinical laboratory measures of glycemic control. We identified 4,434 adults with uncontrolled or medication-controlled type 2 diabetes who had gastric bypass.

RESULTS:

Overall, 68.2 % (95 % confidence interval [CI], 66 and 70 %) experienced an initial complete diabetes remission within 5 years after surgery. Among these, 35.1 % (95 % CI, 32 and 38 %) redeveloped diabetes within 5 years. The median duration of remission was 8.3 years. Significant predictors of complete remission and relapse were poor preoperative glycemic control, insulin use, and longer diabetes duration. Weight trajectories after surgery were significantly different for never remitters, relapsers, and durable remitters (p = 0.03).

CONCLUSIONS:

Gastric bypass surgery is associated with durable remission of type 2 diabetes in many but not all severely obese diabetic adults, and about one third experience a relapse within 5 years of initial remission. More research is needed to understand the mechanisms of diabetes relapse, the optimal timing of surgery in effecting a durable remission, and the relationship between remission duration and incident microvascular and macrovascular events.

Gastric Bypass

Living on borrowed time – Health Benefits of Gastric Bypass Surgery Persist for Six Years

“It’s very relevant,” Dr. Ponce said. “There were tremendous benefits with the surgical group. The control groups showed if you don’t do surgery, the patients will continue to have diabetes. The longer you leave it alone, the more problems you’ll have.”

1-s2.0-S0001299812000554-gr3

Radioactive MM.

Late Monday night my neurologist's secretary called to say that my PET Scan and MRI appointments were cancelled and please not to come in.  However, considering that this was the third (or… fourth?) cancellation in a row my husband called the health insurer Just To Make Sure, and it appeared we were okay – and had all the authorizations and Please Go Create More Debt!  Instead of wasting four hours in traffic in total to be sent home — we waited to the very last minute and called the hospital to MAKE DAMN SURE I could still go in.  "And, I … guess?"  

I think until you play this game of insurance-merry-go-NO-we-don't-want-to-pay-for-anything you won't get it.  This drags every process out over months.  Consider that I have had seizures since AT LEAST 2006 or 2007 (I did not realize what they were…) and that my medical treatment is really JUST getting underway, now.

Scary.

Yes.

AND THE INSURANCE COMPANY — "Well, we aren't so sure she needs that test, could you offer more proof that she needs brain imaging?"   Sure!  COME TO MY HOUSE Mr. Cigna.  Live with me for a week.  I'll show you seizures!  

The testing. 


The PET Scan was super simple, after I walked in and was given the: "Um, your appointment was cancelled?"  I just told the girl at the desk, "Yes, well, we spent all morning on the phone about THAT," and I looked away.  

Two minutes later, she's got my bracelet on, and the nurse has my IV in.

You get a simple glucose injection and have to sit quietly for 45 minutes and let your brain rest.  I am not good at that, so I got in trouble for picking up a magazine.  "BAD, BAD BETH."  The scan itself was no big deal, it was quiet, and quick.  As soon as I started to feel like I had enough — it was over.  

The MRI.  Do not want.  I have had enough brain MRIs to know they suck — they are loud and obnoxious, and I do everything I can to NOT ENVISION my brain being sliced into deli meat.  Because I Do.  The Whole Time. 

These two tests will give a clearer picture of the activity source in my brain like this:

1-s2.0-S0001299812000554-gr3

Not MY brain … HOWEVER …

 The MRI – the non seizure brain – the seizure brain – the mixed scans – and VOILA – you can see the seizure focus!  Again, not my brain, however, my will appear somewhat similar.  

PS.  If you do not want to receive neurology updates – remember – this is my personal blog.  If you're still here, thank you!  

Bariatric surgery for diabetes tops innovation rankings

Cleveland Clinic announced its list of Top 10 Medical Innovations that will have a major impact on improving patient care within the next year. The list of breakthrough devices and therapies was selected by a panel of Cleveland Clinic physicians and scientists and announced today during Cleveland Clinic’s 2012 Medical Innovation Summit.

And, number one —

Via Cleveland Clinic

1. Bariatric Surgery for Control of Diabetes 
Exercise and diet alone are not effective for treating severe obesity or Type 2 diabetes. Once a person reaches 100 pounds or more above his or her ideal weight, losing the weight and keeping it off for many years almost never happens.

While the medications we have for diabetes are good, about half of the people who take them are not able to control their disease. This can often lead to heart attack, blindness, stroke, and kidney failure.

Surgery for obesity, often called bariatric surgery, shrinks the stomach into a small pouch and rearranges the digestive tract so that food enters the small intestine at a later point than usual.

Over the years, many doctors performing weight-loss operations found that the surgical procedure would rid patients of Type 2 diabetes, oftentimes before the patient left the hospital.

Many diabetes experts now believe that weight-loss surgery should be offered much earlier as a reasonable treatment option for patients with poorly controlled diabetes —and not as a last resort.

Does your proximity to a bar increase your RISK for alcoholism?

Does a person's proximity to a bar trigger over-indulgence?  

A recent study suggests (Duh?!) perhaps it ACTUALLY DOES!  To bring the weight loss surgery community into it — consider locality of bariatric-themed community events.  Where Do The Food Addicts Gather At These Events? Which events get the most attendance?  

Roux-en-Y_GBP

Gastric Bypass Benefits Persist at 6 Years’ Follow-Up : Surgery News

Gastric Bypass Benefits Persist at 6 Years' Follow-Up : Surgery News.

Roux-en-Y_GBP

Both weight loss and its associated improvements in cardiovascular and metabolic risk factors persisted for 6 years in most of the 418 severely obese adults who underwent Roux-en-Y gastric bypass surgery in a prospective study published in the Sept. 19 JAMA.

  • Results from JAMA  Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, −1.1% to 1.4%) gain in control group 1 and 0% (95% CI, −1.2% to 1.2%) in control group 2. 
  • Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P < .001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P < .001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P < .001). The numbers of participants with bariatric surgery–related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively.