Management of Obesity Flashcards
What co-morbidities are associated with obesity?
Asthma, cancer, CVD, dementia, depression, type II diabetes, fertility problems, GORD, kidney and liver disease, osteoarthritis and acute pancreatitis
Describe the adult weight management pathway
Tier 1 - population wide health improvement work
Tier 2 - primary care
Tier 3 - specialist weight management
Tier 4 - specialist surgical service
What is the non-surgical weight management option?
Orlistat - inhibits pancreatic and gastric lipases
GI adverse reactions with consumption of fat
What are the 3 types of bariatric surgery?
Gastric band, gastric sleeve and Roux en Y gastric bypass
When is bariatric surgery considered?
BMI> 35kg/m
Presence of one or more severe comorbidities which is suspected to improve following surgery
What is the criteria to access tier 4 services?
Individuals between 18-44 with BMI 35-40 and recent type II diabetes onset
BMI 40-50 with type 2 diabetes diagnosed within 5 years
What are the advantages and disadvantages of intra gastric balloon?
Non operative weight loss option, removable and BMI 27-50
Potential regain after removal and complications - large hiatus hernia, PUD and anticoagulation
When is obesity surgery given?
Around BMI 35-40
What are the common problems following weight loss surgery?
Constipation, dehydration, hair loss and excess skin
What nutrient supplements are given after surgery?
Iron, B12, vit D, multivitamins and minerals
What tests are used to diagnose diabetes?
Random venous plasma glucose > 11.1mmol/l
Fasting plasma glucose >7mmol/l
2 hour plasma glucose >11.2mmol/l in OGTT
HbA1c >48mmol/mol
When is HbA1c used for diagnosing in diabetes?
Children and young people, suspected type I, symptoms less than 2 months, acutely ill, medications, acute pancreatic damage and pregnancy
What point of care testing is done for diabetes?
Urine testing - glycosuria and ketonuria
Glucose meter - measurement of capillary blood glucose
What is factitious hypoglycaemia?
High insulin levels in absence of elevated C peptide concentrations
What results are seen in an insulinoma?
Elevated C peptide level indication of insulin secreting tumour
