Treatment of Obese Patients With Type 2, Essay Example

Bariatric Surgical and Procedural Interventions in the Treatment of Obese Patients with Type 2 Diabetes

Like HIV/AIDS, Diabetes and obesity are major issues in the worldwide health scene. As a result, it requires special focus from all the administrations of countries on the planet. The main threat posed by the two entails the escalation of complicated metabolic failures that advance risks associated with the loss of life and the notion of unwholesomeness (Sjöström, 2013). The regulation of the commencement rate of these maladies is dependent on attempts of the people and health providers (Dixon, Zimmet, and Rubino, 2011). On the hand, the people ought to lead healthy lives majorly through their dietary comportment and physical education.  Health provision setups should strive to establish more efficient therapeutic strategies (International Diabetes Federation, 2014).In most cases, practitioners have resorted to utilizing surgical procedures on the gastrointestinal tract. In that sense, this paper is set to provide details of the most recent surgical intervention, known as, Bariatric surgery. It discusses the concepts that make this exercise appropriate based on a research statement by the global Diabetes parties and Taskforce on Epidemiology practices

It is essential to establish the connection between diabetes and obesity prior to looking at the surgical intervention. Obesity is the basic causative agent of Type 2 diabetes (Dixon, Zimmet, and Rubino, 2011). It is estimated that obese males are 42 times more likely to acquire diabetes compared to those with normal weight (Kendall, Amin, & Clayton, 2014).  On the other hand, female are 93 time more probable of acquiring this condition compared to their counterparts with normal weight (Kendall, Amin, & Clayton, 2014).  This is further supported by the fact that only 15% of people normal weight suffer from diabetes. Obesity causes hypertension and dyslipidemia which subsequently lead to diabetes. Medics prefer natural weight loss methods in controlling diabetes. These ways are physical exercises and a low-fat diet (Choi & Kasama, 2014).

Bariatric surgery in diabetes treatment is suitable for persons with a Basal Metabolic Index (BMI) of between 30 and 35 that cannot receive their target suggested media targets and therapies (International Diabetes Federation, 2014).These indices are usually associated with cardiovascular disease risk factors, which prevent the optimal medical regimen from controlling diabetes (Dixon, Zimmet, and Rubino, 2011).  Originally, Bariatric surgery was meant to reduce weight loss exclusively. However, recent studies have resolved that it helps in controlling diabetes. This is because it alters the equilibrium of energy, through a diminution of food intake and adjustment of physiological changes (Kendall, Amin, & Clayton, 2014).  This procedure normalizes conditions such as; hypertensions, hyperglycemia, obstructive sleep anopnea, hyperlipidemia, and overall progressive eminence of life. Due to this, it is also referred to as Bariatric Metabolic Surgery (Dixon, Zimmet, and Rubino, 2011). A successful bariatric surgical procedure should produce the following results: HbA1c of the less than or equal to 6%, total cholesterol <4 mmol/l; LDL cholesterol<2 mmol/l; triglycerides<2.2 mmol/l, BP>135/85 mmHg, >15% weight loss, and no hypoglycemia. Meanwhile, an advancement in metabolism is illustrated by; LDL<2.3 mmol/l, BP<135/85 mmHg, lowered HbA1c by at least 20%, and a reduction of medication from the pre operated condition (Dixon, Zimmet, and Rubino, 2011).

There are a number of policies and procedures that should be taken into account during bariatric surgery. Most significantly, it ought to be performed in centers with high volume with teams from various disciplines (International Diabetes Federation, 2014).The members of these teams are expected to illustrate a high-level understanding and experience in administration of obesity and diabetes. In addition, it is essential for the team members to work based on common goals and expectations (Klingensmith, Aisenberg, Kaufman, Halvorson, Cruz, Riordan, & Bailey, 2013).  As if not enough, they should integrate basic care, organization of diabetes, alongside dietetic `and support of daily life (International Diabetes Federation, 2014). Another vital requirement is the obligation of the surgical team to undergo a supervised justifying their expertise on various forms of bariatric surgical procedures (Hakim, 2011). Efficient preparation enables the team to make out early and long-term complications associated with the procedure in good time. Upon a successful completion of an operation, there is a need for an all-time follow-up on a yearly basis (Kendall, Amin, & Clayton, 2014).   This ensures the patients follow their dietary prescriptions. Also, it enables physicians to monitor the status of micronutrients and the existence of personalized nutritional supplements (Klingensmith, Aisenberg, Kaufman, Halvorson, Cruz, Riordan, & Bailey, 2013).   Some of the follow-up strategies, among others, include psychosomatic assessment, sustenance, and rehabilitation (Benotti, 2014).

In spite of the positive aspects of Bariatric surgery, there are several risks in relation to it this system. Anastomotic and staple leaks account for 3.1% of the risks. On the other hand, the wound infections contribute to 2.3% of the concerns. In addition, hemorrhage leads to 1.7% of the issues (Kendall, Amin, & Clayton, 2014).  This calls for ongoing hard work for surveying safety, efficiency, and long-term implications of bariatric surgery (Klingensmith, Aisenberg, Kaufman, Halvorson, Cruz, Riordan, & Bailey, 2013). Besides, there is a need for establishing how bariatric surgery can be applied to persons with a BMI of less than 35 (Klingensmith, Aisenberg, Kaufman, Halvorson, Cruz, Riordan, & Bailey, 2013). Finally, the researchers should clearly outline the appropriate duration of benefits connected with the surgery (International Diabetes Federation, 2014).

In a nutshell, the paper provides critical insights concerning the bariatric surgical procedure through highlighting the fundamentals of the system. It starts by explaining the nexus between obesity and Type 2 diabetes. Here, it emphasizes that obesity brings out conditions like hypertension and hyperglycemia that increase the risk of acquiring diabetes mellitus. Another section discusses the whole concept of bariatric surgery. In this case, one vital thing one learns is that only individuals with a BMI of between 30 and 35 are suitable for the procedure. Also, this part highlights the parameters that determine the success of this process. For instance is a BP of less than 135/85 mmHg. The study also reviews the guidelines for the procedure. An example of such a guideline is centered on the supervision of training by the proposed professional team for an operation. Finally, there is a focus on the risks of the procedure and some recommendations for improvement. This paper is a perfect model on the essentials of bariatric surgery.

References

Benotti, P, N. (2014). Patient preparation for bariatric surgery. New York, NY: Springer.

Choi, S. H., & Kasama, K. (2014). Bariatric and metabolic surgery. Berlin: Springer.

Dixon, J.B., Zimmet, P., and Rubino, F. (2011). Bariatric Surgery: An IDF Statement for Obese Type 2 Diabetes, Journal of an International Diabetes Federation, 3-14 Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3123702/

Hakim, N. (2011). Bariatric surgery. London: Imperial College Press.

International Diabetes Federation. (2014). Bariatric Surgical and Procedural Interventions in the Treatment of Obese Patient with Type 2 Diabetes, 10-35. Retrieved from https://www.bakeridi.edu.au/Assets/Files/IDF-Position-Statement-Bariatric-Surgery.pdf

Kendall, D., Amin, R., & Clayton, P. (2014). Metformin in the Treatment of Obese Children and Adolescents at Risk of Type 2 Diabetes. Pediatric Drugs, 16(1), 13-20.

Klingensmith, G. J., Aisenberg, J., Kaufman, F., Halvorson, M., Cruz, E., Riordan, M. E., & … Bailey, T. (2013). Evaluation of a combined blood glucose monitoring and gaming system (Didget®) for motivation in children, adolescents, and young adults with type 1 diabetes Evaluation of a combined blood glucose monitoring and gaming system (Didget®). Pediatric Diabetes, 14(5), 350-357.