Recurrent Diabetic Ketoacidosis following Bariatric Surgery: The Role of Micronutrients

Moseley, Philip; Ahmed, Mohamed H.; Owles, Henry

doi:10.1055/s-0041-1731139

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Therefore, it is crucial to look for micronutrient deficiencies in individuals with RYGB. [ 24 , 25 ] Although the case provide level V eivdence, the patient journey support the relevience of selenium and zinc testing and monitring in patients experiencing delayed wound healing and infection. Furthermore, it highlights the important role of primary care and family medicine physicians in ensuring adequate compliance with suplementation of micronutrients as this will be lifelong process.…”

Section: Discussionmentioning

confidence: 99%

Recurrent abdominal laparotomy wound infection and dehiscence in a patient with zinc and selenium deficiency associated with Roux-en-Y gastric bypass: Case report and literature review

Chizooma,

Fabyan,

Panda

et al. 2023

Journal of Family Medicine and Primary Care

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We report a case of a 72-year-old woman who developed recurrent abdominal laparotomy wound dehiscence and infection following a hepatico-jejunostomy. Her surgical history included a Roux-en-Y gastric bypass (RYGB) that was carried out 11 years ago. Upon further assessment in the current admission, she was found to be deficient in both selenium and zinc. Daily multivitamin and mineral tablets and a nutritional supplement drink were prescribed to address her deficiencies. After 2 months of supplementation, the laparotomy wound had made significant healing progress and no further surgical input was required. This case illustrates the importance of assessing micronutrient levels in patients with a history of bariatric surgery who present with poor wound healing and infection. Bariatric patients should also be educated about the risks of nutritional deficiencies and encouraged to adhere to prescribed dietary and lifestyle changes. Importantly, family medicine and primary care physicians need to consider an adequate level of supplementation of micronutrients in all patients with RYGB surgery.

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Section: Discussionmentioning

confidence: 99%

Recurrent abdominal laparotomy wound infection and dehiscence in a patient with zinc and selenium deficiency associated with Roux-en-Y gastric bypass: Case report and literature review

Chizooma,

Fabyan,

Panda

et al. 2023

Journal of Family Medicine and Primary Care

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“…showed in another case report that thiamine deficiency can lead to DKA following bariatric surgery in an individual with type 1 diabetes. [ 26 ] Interestingly, an ongoing randomised control trial (RCT) looked at the impact of thiamine replacement on recovery from acidosis due to DKA. They will also investigate the relationship between thiamine and cellular oxygen consumption in addition to the effects of thiamine on intensive care and hospital stays.…”

Section: Methodsmentioning

confidence: 99%

Thiamine deficiency in diabetes, obesity and bariatric surgery: Recipes for diabetic ketoacidosis

Panda,

Heidari,

Borumand

et al. 2024

Journal of Family Medicine and Primary Care

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Diabetic ketoacidosis (DKA) is a life-threatening condition affecting individuals with diabetes characterised by hyperglycaemia, metabolic acidosis and ketonemia. The incidence and financial burden of DKA is still high. Thiamine deficiency is well documented in patients with DKA and could be associated with cardiac dysfunction in those patients. Thiamine deficiency leads to cardiac dysfunction, neuronal death and worsens the prognosis of DKA. There is an existing metabolic relationship between thiamine deficiency in diabetes, obesity and bariatric surgery. Careful monitoring of thiamine, along with other vitamins, is essential for diabetic patients, obese individuals and postbariatric surgery. Further research and clinical studies are urgently needed to assess the following: (1) Whether diabetes, obesity and bariatric surgery make individuals more prone to have DKA related to thiamine deficiency and (2) Whether supplementation of thiamine can protect diabetic patients, obese subjects and individuals undergoing bariatric surgery from DKA. This review summarises the biochemistry of thiamine and the existing metabolic relationships between thiamine deficiency in DKA, diabetes, obesity and bariatric surgery. Primary and family physicians have an important role in ensuring adequate replacement of thiamine in individuals with diabetes, obesity and bariatric surgery.

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Recurrent Diabetic Ketoacidosis following Bariatric Surgery: The Role of Micronutrients

Cited by 2 publications

References 15 publications

Recurrent abdominal laparotomy wound infection and dehiscence in a patient with zinc and selenium deficiency associated with Roux-en-Y gastric bypass: Case report and literature review

Recurrent abdominal laparotomy wound infection and dehiscence in a patient with zinc and selenium deficiency associated with Roux-en-Y gastric bypass: Case report and literature review

Thiamine deficiency in diabetes, obesity and bariatric surgery: Recipes for diabetic ketoacidosis

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