Behaviour change and type 2 diabetes remission

Question 1

RYGB bypass

Answer 1

Stomach is divided and a proximal pouch is created. A gastro-jejunal anastomosis is created with the remnant stomach, duodenum and jejunum excluded from nutrients transit

Question 2

Vertical sleeve gastrectomy

Answer 2

A gastric resection is performed along the smaller curvature using staplers, leaving behind a ‘sleeve-shaped’ stomach without rerouting intestine

Question 3

Laparoscopuc adjustable gastric banding

Answer 3

An inflatable band is placed around the upper stomach which is inflated by injecting saline

Question 4

Biliopancreatic diversion

Answer 4

Stomach is resected horizontally or vertically, bypassing the duodenum, jejunum and part of the ileum

Question 5

Package of care after bariatric surgery

Answer 5

Monitoring nutritional intake
Monitoring for comorbidities
Medication review
Dietary and nutritional assessment

Question 6

HbA1C for remission

Answer 6

under 49 - 42-48 indicates pre-diabetes

Question 7

How does remission reverse diabetes?

Answer 7

reduces fatty build up inside liver and pancreas so insulin is more effective again

Question 8

Diet for remission

Answer 8

• CICO = calories in calories out
• low GI
• Low carbs
• Low carb high fat
• keto diet
• 5:2 or intermittent fasting