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Daily Archives: Oct 16, 2018

Oct. 16, 2018

We work very hard with our patients to help them lose weight. Often it is a slow and agonizing process but it will work. Many of our patients choose to have a surgical procedure like lap band, sleeve gastrectomy or bypass. When you look at the procedures they may all …

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Take a Second Look at Surgery Recommendations

Patient is male, 48 years of age, type 2 diabetes with hyperglycemia for eight years, class III obesity,  and very symptomatic GERD. Patient planned to have laparoscopic sleeve gastrectomy. I asked him why he chose that particular surgery. He said, "Because it's less invasive." I asked if his surgeon told him the sleeve gastrectomy could increase his GERD, and is not as effective for the treatment of type 2 diabetes nor for weight loss as is a bypass. He said, "No, the surgeon just left it to my choice. I said I wanted the sleeve and he was good with that."

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Joshua Safer Complete Interview

Joshua Safer, MD, FACP, is the Executive Director of the Mount Sinai Center for Transgender Medicine and Surgery in New York. Previously, he was the inaugural Medical Director of the Center for Transgender Medicine and Surgery at Boston Medical Center. He is also Senior Faculty at the Icahn School of Medicine at Mount Sinai.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #147: Glucose Toxicity Part 3

Chronic hyperglycemia as a cause of impaired insulin secretion In 1948, Lukens and Dohan administered large doses of glucose to normal cats and induced permanent hyperglycemia, hydropic degeneration of the islet of Langerhans, and ketonuria in 4 out of 35 cats studied. These investigators proposed that hyperglycemia could play a role in the pathogenesis of diabetes. In recent years, several approaches have been used to directly examine the harmful effects of chronic hyperglycemia on insulin secretion. These studies have established that chronic hyperglycemia impairs beta-cell responsiveness to glucose although the exact biochemical mechanism(s) mediating this effect remain to be clearly defined.

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