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KMID : 0664320110170020206
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Journal of the Korean Dietetic Association
2011 Volume.17 No. 2 p.206 ~ p.215
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Medical-Nutrition-Therapy for Obese Patients with Type 2 Diabetes Mellitus Undergoing Metabolic Surgery
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Kim Hye-Jin
NamGung Sin-A
Hong Jeong-Im
Mok Hee-Jung
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Abstract
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Currently, metabolic surgery (Laparoscopic Roux-en-Y gastric bypass, LRYGB) has an important role and should be recommended as an intervention in the management of obese patients with type 2 diabetes mellitus (T2DM). A successful outcome of surgery requires medical nutrition therapy. Therefore, we performed a retrospective study on 25 patients with T2DM who underwent LRYGB at Yeouido St. Mary’s Hospital from October 2008 to May 2010. The patients were followed up for an average of 6 months after surgery (range: 2∼19 months). Diabetes was resolved in 80% of the patients. Percentage of excess weight loss was (%EWL) was 56.2%. After surgery, fasting blood sugar (FBS) and HbA1c were significantly reduced (123 mg/dl, A1c 6.7%, P＜0.001) and triglyceride was also significantly reduced to 107.6 mg/dl (P＜0.05). As diets of the patients progressed from liquid to soft to regular diet, energy, carbohydrates, and fat intakes increased significantly (P＜0.001). But protein intake did not change significantly. Nutrient intake of the patients after the
surgery was significantly lower than the recommended diet for the non-surgery group. Patients experienced side-effects related to the diets after surgery, including hair-loss (76%), smelly gas (52%), vomiting (48%), etc. A significantly positive correlation was observed between vomiting and FBS (P＜0.001). There was a significant relationship between side effects and the amount of nutrient intakes. Therefore, guide patients to a diet progression with treatment to minimize side effects, especially vomiting. And monitor their dietary life to be healthy and not to regain weight until remission of T2DM.
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KEYWORD
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Laparoscopic Roux-en Y gastric bypass, LRYGB, metabolic surgery, medical nutrition therapy, diabesity, T2DM
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