Managing obesity to prevent diabetes

Slides (presentatie) - 9 nov. 2011

Managing obesity to prevent diabetes

Dr. Rachel Batterham – Reader in Diabetes, Endocrinology and Obesity and Honorary Consultant
UCL Division of Medicine, London, United Kingdom

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Cardiovascular Exchange Summit 2011


Global Burden of Obesity

Trends in adult obesity from around the world

Type 2 Diabetes (T2DM)

Obesity and Type 2 Diabetes

Diabetes and Weight Loss

The Need to Feed

NICE clinical guideline 43

Treatment options


Dieting vs. Bariatric Surgery


Types of Bariatric Surgery

Percent of excess weight lost post-surgery

Health Benefits of Bariatric Surgery

Resolution of co-morbidities

Risks of Bariatric Surgery

Nutritional Deficiencies

Effect of operation on DM

T2DM & Bariatric Surgery

Metabolic Surgery

Roux-en Y Gastric Bypass (RYGBP) ‘Gold standard’

Gut hormones control body weight& blood sugar

Ghrelin: a unique orexigenic hormone

Ghrelin stimulates hunger and food intake in normal-weight volunteers

Obese subjects have reduced ghrelin levels

Peptide YY (PYY)

Obese humans and mice have low circulating levels of PYY

Glucagon-like peptide 1 (GLP-1)



Increased food availability

PYY3-36 modulates homeostatic and reward regions

Ghrelin modulates neuronal activity in homeostatic and reward regions

Role of ghrelin in obesity

PYY and Dieting

Ghrelin and Bariatric Surgery

Gastric bypass surgery reduces hunger and increases satiety

Study Design

Anthropometric Data

Appetite Ratings

Changes in PYY post-RYGB

Changes in GLP-1 post-RYGB

Changes in acyl-ghrelin post-RYGB

Are the changes in PYY3-36 and active GLP-1 due to weight loss?

Metabolic Surgery in T2DM with BMI ≤ 35 kg/m2

International Diabetes Federation

Take home messages

How Does Obesity Surgery Cause Weight Loss and Cure Type 2 Diabetes?

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