Diabetes improved regardless of surgical procedure

ScienceDaily (May 7, 2012) — New research reports that no procedure for weight loss surgery is any better at treating diabetes than another. The study, presented May 7 at the International Congress of Endocrinology/European Congress of Endocrinology in Florence, Italy, uses a large ongoing study to show that improvements to diabetes in patients undergoing such surgery is likely to be due to the degree of weight loss itself rather than the type of procedure.

See Also:Health & MedicineDiet and Weight LossObesityDiabetesWounds and HealingGastrointestinal ProblemsFitnessReferenceDiabetes mellitus type 2Blood sugarRefractive surgeryHysterectomy

A number of procedures for weight-loss surgery (termed 'bariatric surgery') have been developed which can work by reducing the functional size of the stomach ('restriction'), reducing the capacity of the gut to absorb calories ('malabsorption') or by a combination of the two. The well-documented improvement in diabetes following such surgery has puzzled doctors but the evidence suggests it is due in part to the altered transit of food through the gut. It is therefore possible that different procedures would give different degrees of improvement. This is what Associate Professor Markku Peltonen at the National Institute for Health and Welfare, Finland and colleagues from the University of Gothenburg, Sweden, set out to investigate using data from the large 'Swedish Obese Subjects' study.

2010 severely obese patients (with BMI>34 in men and >38 in women) recruited to the study went on to receive bariatric surgery: 376 gastric banding, 265 gastric bypass (GBP), and 1369 vertical banded gastroplasty (VBG -- see below for descriptions). They followed 74% of these patients at both 2 and 10 years and measured improvements in diabetes via blood glucose and insulin levels before and after surgery. The degree of weight loss was categorised as more than 30kg, 30-25kg, 25-20kg and 20-15kg. Improvements in blood glucose and insulin were then compared between the three different surgical procedures accounting for the degree of weight loss.

After 10 years, the researchers found there was no significant difference in the changes to insulin and glucose levels between the three surgical groups when the extent of their weight loss was taken into account. This was true for patients with and without diabetes at baseline. The average 10 year weight losses were 18kg, 20kg and 29kg for the banding, GBP and VBG groups respectively (p<0.001). In a further analysis patients that lost the same amount of weight improved their blood glucose and insulin levels to similar degrees, regardless of the type of surgery.

The researchers conclude that the remarkable improvements in diabetes following weight loss surgery are not a direct result of the procedure itself. More research now needs to take place to investigate why bariatric surgery can cure diabetes in these patients, and why some patients respond better than others.

Associate Professor Markku Peltonen, Director of Department at the National Institute for Health and Welfare, Finland, said:

"Bariatric surgery is clearly effective in reducing weight in patients, but the current mystery is why so many patients appear to cure themselves of diabetes shortly after the operation.

"We would expect that some methods of weight loss surgery would be more effective at treating diabetes than others due to the different ways they alter the passage of food through our gut. When we factored in the weight lost following surgery we found that no procedure was any better at treating diabetes than another.

"Perhaps it is simply the act of losing weight that helps."

Bariatric Surgery

Gastric banding reduces the functional size of the stomach by fitting a belt around the top section, so that it requires very little food to fill and therefore produces 'satiety' hormones after less food. The food is allowed to slowly pass into the main chamber of the stomach to continue digestion as normal. Adjustable gastric bands can be tightened or loosened to control this rate.

Gastric bypass surgery staples off the top portion of the stomach and creates a new route for food from this top portion to the small intestine, thus reducing the functional size of the stomach and bypassing much of the digestion and absorption that occurs in the stomach and small intestine. Bypassing more of the small intestine gives more rapid weight loss.

Vertical banded gastroplasty is a similar technique to gastric banding but is more complex.

Other techniques have been developed, although they are not covered as part of this study.

Share this story on Facebook, Twitter, and Google:

Other social bookmarking and sharing tools:

View the Original article

Dental Fillings Are a Critical Dental Care Procedure For Healthy Teeth

April 16, 2012 by admin

Dental filling refers to the use of dental restorative substance to rebuild the functionality, integrity and morphology of a broken or missing tooth. Such a tooth breakage or loss may occur due to an internal tooth disintegration caused by caries, or due to an external accident. General dentists and even cosmetic dentists usually perform this procedure on patients. Among Chicago Cosmetic Dentist clinics, there are several clinics that undertake various dental restoration procedures.

Dental filling or dental restoration can be broadly categorized into two categories: Direct restoration and Indirect restoration. The restoration can be further sub-divided on the basis of its location, nature and size. A common tooth restorative procedure is the root canal filling that fills the gap where the dental pulp is usually present.

Tooth preparation is a key procedure that is followed before the dental restorative process can start.

Under this process the tooth is basically cut with a dental drill in order to create space for the restoration that has to take place. It also requires removal of any tooth decay and any such teeth that may be weak in structure. Once tooth preparation has been completed, the process of restoration is conducted. The restoration can be permanent or temporary in nature, depending upon the condition of the teeth.

There are various Chicago Cosmetic Dentist clinics that undertake both direct as well as indirect tooth restorations and perform the job competently.

Direct restoration: This is a method involving the placement of a soft filling substance into the prepared tooth space and helping to build up the tooth before the filling material hardens.

The advantage of a direct tooth restoration technique is that it mostly sets the tooth quickly. Normally it may take just one visit to the dental clinic to finish this procedure. It is mostly recommended where the damage or tooth space is small and not too significant. But wherever a lot of strength may be necessary for the tooth, an indirect restoration would be a better option.

Indirect restoration: Under this procedure, the dental impression from the patient’s mouth is taken, and a restorative material is fabricated externally. Thereafter the tooth preparation process is conducted, followed by the restorative process. Some of the popular indirect restorations include inlay and onlay, crown, bridge and veneer. Once the indirect restorative material has been fabricated, it is normally bonded with a permanent dental adhesive or dental cement. Usually this procedure will take at least two trips to your dentist. The indirect restoration substances commonly used are gold or ceramic for they have a long-lasting value and durability.

Mostly, when the indirect restorative fabrication is getting ready, a temporary restoration may be carried out in order cover and protect the prepared part of the tooth in order to safeguard the peripheral dental tissue.

Dental

View the Original article