Caring for patients after bariatric surgery: New clinic offers help
Elif Oral, M.D., (left) director of both the Bariatric Surgery
Weight returning after bariatric surgery is a reality for many patients. And research has shown that patients who continue specialty care after bariatric surgery with physicians who have expertise in obesity medicine and or dieticians do better in the long run, with more successful weight loss.
One challenge is managing patients' metabolic conditions.
"At least 50 percent of patients seeking bariatric surgery are diabetic and bariatric surgery is now being looked at as an intervention to treat and cure diabetes," says Elif Oral, M.D., assistant professor of internal medicine in the Division of Metabolism, Endocrinology and Diabetes at U-M. "In the future, endocrine specialists will probably have more of a role in referring patients to bariatric surgery and also to follow and guide diabetes related care and surveillance for complications in the years to come. As a corollary, bariatric surgeons are getting more and more involved in the treatment of diabetes."
Another concern with these patients is prevention and management of metabolic complications. For example, some types of surgery lead to vitamin D and calcium deficiency.
It may take as much as 12 to 18 months for complications to set in, especially if the patients neglect to take their supplements," says Oral. "Occasionally, problems with hypoglycemia are seen too."
To help these patients, whether or not they had their bariatric surgery at U-M, the U-M Health System has launched a new Post-Bariatric Surgery Clinic to help with ongoing care for patients after follow-up with their surgeon has ended. The clinic opened in fall 2010 and is located in Domino's Farms, Lobby C in the Metabolism, Endocrinology and Diabetes Clinic site.
Oral, who is medical director of the U-M Bariatric Surgery Program, is the clinic's director. Andrew Kraftson, M.D., clinical instructor in internal medicine, and Angela Subauste, M.D., assistant professor of internal medicine, are co-directors. The dietitians are Catherine Kraus and Amy Lockwood.
U-M performs three types of bariatric surgery: laparoscopic gastric bypass, adjustable band, and sleeve gastroectomy. The U-M Bariatric Surgical team also runs a collaborative of all bariatric surgery programs throughout the state of Michigan. Patients who come through any bariatric surgery program in Michigan can be referred to the Post-Bariatric Surgery Clinic for follow-up care.
FOR MORE INFORMATION
Metabolism, Endocrinology & Diabetes (MEND): www.med.umich.edu/intmed/endocrinology/index.htm
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