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Cardiovascular Exchange Summit 2011
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Definitions
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Global Burden of Obesity
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Trends in adult obesity from around the world
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Type 2 Diabetes (T2DM)
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Obesity and Type 2 Diabetes
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Diabetes and Weight Loss
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The Need to Feed
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NICE clinical guideline 43
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Treatment options
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BARIATRIC SURGERY NICE GUIDELINES (CG43)
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Dieting vs. Bariatric Surgery
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Procedures
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Types of Bariatric Surgery
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Percent of excess weight lost post-surgery
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Health Benefits of Bariatric Surgery
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Resolution of co-morbidities
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Risks of Bariatric Surgery
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Nutritional Deficiencies
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Effect of operation on DM
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T2DM & Bariatric Surgery
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Metabolic Surgery
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Roux-en Y Gastric Bypass (RYGBP) ‘Gold standard’
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Gut hormones control body weight& blood sugar
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Ghrelin: a unique orexigenic hormone
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Ghrelin stimulates hunger and food intake in normal-weight volunteers
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Obese subjects have reduced ghrelin levels
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Peptide YY (PYY)
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Obese humans and mice have low circulating levels of PYY
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Glucagon-like peptide 1 (GLP-1)
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Liraglutide
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Liraglutide
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Increased food availability
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PYY3-36 modulates homeostatic and reward regions
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Ghrelin modulates neuronal activity in homeostatic and reward regions
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Role of ghrelin in obesity
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PYY and Dieting
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Ghrelin and Bariatric Surgery
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Gastric bypass surgery reduces hunger and increases satiety
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Study Design
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Anthropometric Data
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Appetite Ratings
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Changes in PYY post-RYGB
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Changes in GLP-1 post-RYGB
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Changes in acyl-ghrelin post-RYGB
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Are the changes in PYY3-36 and active GLP-1 due to weight loss?
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Metabolic Surgery in T2DM with BMI ≤ 35 kg/m2
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International Diabetes Federation
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Take home messages
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How Does Obesity Surgery Cause Weight Loss and Cure Type 2 Diabetes?
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