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Vitamin B 12 deficiency is quite common after gastric bypass surgery with reported rates of 30% in some clinical trials. [journal 13] Sublingual B 12 (cyanocobalamin) appears to be adequately absorbed. In cases where sublingual B 12 does not provide sufficient amounts, injections may be needed. Protein malnutrition is a real risk.
Vitamin B12: Low serum B12 level is a common finding in diabetics especially those taking Metformin or in advanced age. [73] Vitamin B12 deficiency has been linked to two diabetic complications; atherosclerosis and diabetic neuropathy. [74] [75] Folic acid:
Impaired B 12 absorption can also occur following gastric removal (gastrectomy) or gastric bypass surgery. In these surgeries, either the parts of the stomach that produce gastric secretions are removed or they are bypassed. This means intrinsic factor, as well as other factors required for B 12 absorption, are not available.
A person may need surgery if dumping syndrome is caused by previous gastric surgery or if the condition is not responsive to other treatments. For most people, the type of surgery depends on the type of gastric surgery performed previously. However, surgery to correct dumping syndrome often has unsuccessful results. [1]
Impaired fasting glucose is often without any signs or symptoms, other than higher than normal glucose levels being detected in an individual's fasting blood sample.There may be signs and symptoms associated with elevated blood glucose, though these are likely to be minor, with significant symptoms suggestive of complete progression to type 2 diabetes.
Various methods of gastric bypass or gastric restriction surgery are used to treat morbid obesity. Roux-en-Y gastric bypass surgery (RYGB) but not sleeve gastric bypass surgery or gastric banding, increases the risk of vitamin B 12 deficiency and requires preventive post-operative treatment with either injected or high-dose oral supplementation.
Blood tests may show low levels of vitamin B 12, elevated levels of methylmalonic acid or homocysteine, and a routine complete blood counts may shows anemia with an elevated mean cell volume. [141] The presence of antibodies to gastric parietal cells and intrinsic factor may indicate pernicious anemia .
After performing gastric bypass surgery, the two hormones related to obesity, leptin and insulin, fall in levels and while lose weight. [13] Roux-en-Y (RYGB) offers two surgical approaches for processing: an open technique or the laparoscopic technique. The majority of cases are still performed with laparoscopy. [13]