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Post-bariatric surgery care

Roger Ackroyd

At the 7th National Diabesity Forum conference in July this year, delegates wanted to know more information on post bariatric surgery care once an individual is discharged from the surgical team and returned to primary care. Here, Roger Ackroyd, Consultant General and Bariatric Surgeon at Sheffield Hospital Trust, answers the frequently asked questions based on the procedures carried out in his clinic in Sheffield.

Q When and how often do you see bariatric patients post-surgery? 

After someone has received bariatric surgery, we arrange appointments to see them 1-month post-op and then at 3, 6, 12, 18 and 24 months.

Q What blood tests do you run and when?

We check bloods annually after surgery and test for the following:

  • FBC – Full blood count.
  • U+Es – Urea and electrolytes.
  • LFTs – Liver function tests.
  • TFTs – Thyroid function tests.
  • Fe – Iron.
  • Ca – Calcium.
  • Vitamin D.
  • Folate.
  • Vitamin B12.
  • PTH – Parathyroid hormone.
  • Se – Selenium.
  • Zn – Zinc.

Q When do you suggest stopping anti-diabetes medication?

If they are on oral glucose-lowering medication, we stop them immediately post-op. If they are also on insulin, we also stop this immediately after surgery and then the oral agents a few weeks later if the blood glucose is in the target range.

Q What is included in the long-term care for bariatric patients?

At the clinic in Sheffield, we put them on life-long oral daily multivitamins and 3-monthly vitamin B12 injections.

Q Who in the medical team should review their progress? 

We follow them up in hospital for 2 years (doctors, nurses, dietitians) and then we discharge them back to GP care.

Q What are the first things I need to do as a primary care clinician when bariatric patients return to the surgery’s care? 

Nothing immediately. Just follow them up indefinitely. Annual bloods as above. Nil else specific. Contact the surgical team if you are not sure or have any problems.

If there are any diabesity-related questions that you would like answered, please email them to dip@sbcommunicationsgroup.com

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