J Korean Diabetes.  2011 Sep;12(3):154-158. 10.4093/jkd.2011.12.3.154.

Meal Management for Patients with Type 2 Diabetes Mellitus Undergoing Metabolic Surgery

• Namgung SA

• KMID: 2059841
• DOI: http://doi.org/10.4093/jkd.2011.12.3.154

Abstract

Currently, metabolic surgery (Laparoscopic Roux-en-Y gastric bypass, LRYGB) has an important role in the treatment of type 2 diabetic patients with obesity and should be recommended as an intervention in the management of obese patients with type 2 diabetes mellitus. For the success of bariatric surgery, effective meal management is essential. In the short term meal management, patient meals should be monitored to reduce the side effects after surgery (especially, vomiting). As the insulin sensitivity may be blunt due to stress or inflammation, proper energy intake should be assured, especially that of protein. In long term meal management, essential supplements such as vitamins and minerals should be taken, and healthy dietary life should be recommended to prevent the recurrence of diabetes and weight gain.

Keyword

Diet therapy; Bariatric surgery; Roux-en-Y gastric bypass; Type 2 diabetes mellitus

MeSH Terms

Bariatric Surgery
Diabetes Mellitus, Type 2
Energy Intake
Gastric Bypass
Humans
Inflammation
Insulin Resistance
Meals
Minerals
Obesity
Recurrence
Vitamins
Weight Gain
Minerals
Vitamins

Reference

1. From the NIH: Successful diet and exercise therapy is conducted in Vermont for "diabesity". JAMA. 1980; 243:519–20.

2. Rubino F, Kaplan LM, Schauer PR, Cummings DE. Diabetes Surgery Summit Delegates. The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus. Ann Surg. 2010; 251:399–405.

3. Nelson JK, Moxness KE, Jensen MD, Gastineau CF. Mayo Clinic diet manual: a handbook of nutrition practices. 7th ed.St. Louis, MO: Mosby-Year Book Inc.;1994. p. 197.

4. Kulick D, Hark L, Deen D. The bariatric surgery patient: a growing role for registered dietitians. J Am Diet Assoc. 2010; 110:593–9.

5. Kim HJ, NamGung SA, Hong JI, Mok HJ. Medical-nutrition-therapy for obese patients with type 2 diabetes mellitus undergoing metabolic surgery. J Korean Diet Assoc. 2011; 17:206–15.

6. Ribeiro AG, Costa MJ, Faintuch J, Dias MC. A higher meal frequency may be associated with diminished weight loss after bariatric surgery. Clinics (Sao Paulo). 2009; 64:1053–8.

7. Leite Faria S, de Oliveira Kelly E, Pereira Faria O, Kiyomi Ito M. Snack-eating patients experience lesser weight loss after Roux-en-Y gastric bypass surgery. Obes Surg. 2009; 19:1293–6.

8. Dalcanale L, Oliveira CP, Faintuch J, Nogueira MA, Rondó P, Lima VM, Mendon?a S, Pajecki D, Mancini M, Carrilho FJ. Longterm nutritional outcome after gastric bypass. Obes Surg. 2010; 20:181–7.

9. The Catholic University of Korea St. Mary's Hospital Nutrition Team. Dietary guidelines for Laparoscopic Roux-en Y gastric bypass. Seoul: The Catholic University of Korea St. Mary's Hospital Nutrition Team;2007.

10. Isbell JM, Tamboli RA, Hansen EN, Saliba J, Dunn JP, Phillips SE, Marks-Shulman PA, Abumrad NN. The importance of caloric restriction in the early improvements in insulin sensitivity after Roux-en-Y gastric bypass surgery. Diabetes Care. 2010; 33:1438–42.

11. Heber D, Greenway FL, Kaplan LM, Livingston E, Salvador J, Still C. Endocrine Society. Endocrine and nutritional management of the post-bariatric surgery patient: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2010; 95:4823–43.

12. Strauss BJ, Marks SJ, Growcott JP, Stroud DB, Lo CS, Dixon JB, O'Brien PE. Body composition changes following laparoscopic gastric banding for morbid obesity. Acta Diabetol. 2003; 40(Suppl 1):S266–9.

13. Kruseman M, Leimgruber A, Zumbach F, Golay A. Dietary, weight, and psychological changes among patients with obesity, 8 years after gastric bypass. J Am Diet Assoc. 2010; 110:527–34.

14. American Society for Metabolic and Bariatric Surgery. ASMBS, American Society for Metabolic & Bariatric Surgery [Internet]. Gainesville, FL: ASMBS;2011. [cited 2011 Aug 16]. Available from:. http://asmbs.org.

15. Marcason W. What are the dietary guidelines following bariatric surgery? J Am Diet Assoc. 2004; 104:487–8.

16. Halmi KA, Mason E, Falk JR, Stunkard A. Appetitive behavior after gastric bypass for obesity. Int J Obes. 1981; 5:457–64.