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Metabolic Surgery For Diabetes In India

Metabolic Surgery For Diabetes -- Can It Really Reverse The Disease?

Metabolic Surgery For Diabetes -- Can It Really Reverse The Disease?

Read more about how diabetes can cause kidney failure and strokes. Metabolic surgery is a minimally invasive procedure that aims at negating all the factors that lead to metabolic disease; thereby reversing conditions like type 2 diabetes, PCOD and cardiovascular disease. The surgery affects the various routes through which a person develops metabolic syndrome, namely obesity and lifestyle factors. It involves making the stomach smaller so a person eats lesser, which in turn helps in weight loss and better insulin sensitivity (which is the main reason for diabetes). The surgery also changes the secretion of various gut hormones and helps a person think and respond differently to food. All these factors put together help to change the way a patients body uses blood sugar, thereby reversing type 2 diabetes. Want to try going the natural way instead? Here are 10 tips on how you can do just that. If all the surgery does is help a person lose weight, why cant the same not be done by following a diet and exercise regime? While exercise and a strict diet regime is usually what all patients try, they usually are unsuccessful at their attempts. Moreover if a person suffers from diabetes where his/her blood sugar levels are not controlled; going on an aggressive diet can be dangerous. That is where this surgery comes into play. It gives a patient results in seven to thirty days even before they have lost any significant amount of weight, making it a quick and safe way to tackle the diabetes menace. Moreover with diet and exercise a patient may not achieve complete reversal of the disease, while metabolic surgery can. Who is a good candidate for this surgery? This surgery is most effective on type 2 diabetics whose blood sugar is uncontrolled or not well controlled. While this ma Continue reading >>

Dr Avinash Tank For Metabolic Surgery | Metabolic Surgeon | Diabetes Surgeon | Diabetes Surgery | Diabetes Hospital | Bariatric Doctor In Gujarat | Ahmedabad | India

Dr Avinash Tank For Metabolic Surgery | Metabolic Surgeon | Diabetes Surgeon | Diabetes Surgery | Diabetes Hospital | Bariatric Doctor In Gujarat | Ahmedabad | India

The classification of diabetes includes four clinical classes Type 1 diabetes (results from B-cell destruction, usually leading to absolute insulin deficiency) Type 2 diabetes (results from a progressive insulin secretary defect on the background of insulin resistance) Gestational diabetes mellitus (diabetes diagnosed during pregnancy) Specific types of diabetes due to other causes, e.g., genetic defects in B-cell function, genetic defects in insulin action, diseases of the exocrine pan-creas (such as cystic fibrosis), and drug-or chemical-induced (such as in the treatment of AIDS or after organ trans-plantation) Diabetes is greatest public health threat of the 21st century The world wide cases of Type 2 diabetes are rising dramatically, secondary to increasing sedentary behaviour and easier access to attractive calorie-dense foods. The most recent global predictions by the International Diabetes Federation (IDF) suggest that there are 285 million people with diabetes currently worldwide. This is set to escalate to 438 million by 2030, with a further half billion at high risk.Dr Avinash Tank for Diabetes Surgeon in India, Diabetes Surgeon in Gujarat, Diabetes Surgeon in Ahmedabad. Diabetes is the risk factor for disease of Heart, Eye, Kidney, Nerve & limb vessels Type 2 diabetes is a risk factor for vascular damage: affecting small blood vessels (eye; kidney and nerve) and large blood vessels (premature and more extensive heart, brain and limb blood vessels). Early death and damage to organs in diabetes result from such complications. The disease results from inadequate insulin (hormone that keeps sugar under control) production and action and results in hyperglycaemia (high sugar in blood). In addition, obesity, by itself, generates similar cardio-metabolic dysfunctio Continue reading >>

Surgery Can Control Diabetes In Obese Asian Indian Patients

Surgery Can Control Diabetes In Obese Asian Indian Patients

Surgery can control diabetes in obese Asian Indian patients Study indicates that bariatric surgery is more effective than medical and lifestyle management in controlling type 2 diabetes in Asian Indian population Owen Haskins - Editor in chief, Bariatric News Data from an Ethicon-funded study presented at the American Diabetes Associations annual meeting demonstrates bariatric surgery may be a better treatment option than medical therapy and lifestyle management alone for obese Asian Indian patients with inadequately controlled type 2 diabetes. The COSMID (Comparison of Surgery vs. Medicine for Indian Diabetes) Trial is the first randomized controlled study that specifically addresses the Asian Indian population, which develops type 2 diabetes at an earlier age and a lower BMI than Caucasians. There are more than 300 million people suffering from obesity in India and type 2 diabetes is growing at an alarming rate there, said Dr Elliott Fegelman, Therapeutic Area Expert, Metabolics, Johnson & Johnson Innovations. When compared to Caucasians, the Asian Indian population tends to get sick from diabetes at a lower BMI, but it was unclear if bariatric surgery would be as effective in this less obese population. The COSMID Trial filled that knowledge gap and the results prove that bariatric surgery is more effective at managing and controlling type 2 diabetes than medical and lifestyle management alone for this group. Indias population is the third most obese in the world and obesity is the number one cause of type 2 diabetes in India; over 80 percent of adult diabetics in India are clinically overweight. Asian Indians have a strong ethnic and genetic predisposition for developing diabetes at a younger age and at lower BMI than the Caucasian population. At the same weight as Continue reading >>

Indian Surgeon Claims Surgical Cure For Diabetes

Indian Surgeon Claims Surgical Cure For Diabetes

Indian surgeon claims surgical cure for diabetes Matthew Schneeberger in Mumbai | July 31, 200813:31 IST Last Updated: July 31, 200821:24 IST Dr Shashank Shah, a Pune-based bariatric surgeon, claims to have discovered a surgical cure for type II diabetes, and boasts of an impressive 90% success rate. Should Dr Shah's claims be confirmed, he stands to help solve one of modern medicine greatest dilemmas: how to thwart the growing epidemic of type II diabetes. Leading medical experts in the United States have been impressed with Shah's methods and his data. So much so, that the Cleveland Clinic, one of the world's foremost hospitals, has sponsored an interaction between Dr Shah and 250 of America's top doctors, diabetologists and endocronologists, to happen this Friday. Dr Shah will speak for twenty minutes, via video conference, from the Ruby Hall Clinic in Pune, to doctors and consultants at the Cleveland Clinic and around the country. The topic will be, "Metabolic Surgery for Type II Diabetes in the Asian Context", and afterward, Dr Shah will then be open to the American specialists for questioning. Wednesday afternoon, at the Bombay Press Club, Dr Shah spoke to a smattering of journalists about his discoveries and upcoming video conference. "Bariatric surgery is known as the most effective and longest lasting treatment for morbid obesity and its many related conditions, but now we have reason to believe that it may also be the most-effective treatment for type II diabetes and its accompanying diseases, such as high blood pressure, high cholesterol and coronary heart disease," he said. According to Dr Shah, India is one of the world's hubs of diabetes, and tops the list of countries, with over 35 million diabetes patients within its borders. "Until now, type II diabete Continue reading >>

40-year-old Diabetic Undergoes Bariatric Surgery

40-year-old Diabetic Undergoes Bariatric Surgery

40-year-old diabetic undergoes bariatric surgery Rastogi Vaishali Rastogi with her husband at JJ hospital - Salman Ansari, DNA At 93 kilos, an Indonesian citizen decided to opt bariatric surgery at JJ hospital to control her high blood sugar levels and hypertension. While Vaishali Rastogi was discharged on Thursday after she lost two kilos, the 40-year-old was happy that her insulin intake has been reduced drastically. Doctors say she is the fourth person to undergo bariatric surgery in the past two weeks at the hospital to control diabetes and related complications. Bariatric surgery is increasingly becoming popular, with patients opting for the procedure not just for weight loss. Rastogi is one of them. When she approached us last month, she was on three oral medications and insulin for diabetes and still she had uncontrolled blood sugar levels. She had other medical complications like hypertension and varicose veins. She also had a brain stroke and was under medication for venous thrombosis. We were aghast seeing the number of medicines she had, said Dr Ajay Bhandarwar, professor of surgery, JJ hospital. He added that Rastogi underwent laprascopic mini bypass surgery where around 200 cm of her small intestine was bypassed so that food does not get quickly absorbed in the system. Often labeled as a bariatric procedure, which is done to lose weight, metabolic surgery is in fact a far broader concept that aims to reset organ systems within the body. Small intestine has as many as 10-15 hormones that plays vital role within abdomen to bring about diabetic control, said Dr Bhandarwar. According to the International Federation for Surgery of Obesity & Metabolic Disorder, around 14,000 people undergo weight loss surgery in India every year. Obesity-related conditions, incl Continue reading >>

Type 2 Diabetes | Metabolic Surgery | Complications | Dr. V. Amar

Type 2 Diabetes | Metabolic Surgery | Complications | Dr. V. Amar

Are you thinking of Permanent cure to type 2 Diabetes? Then you should read this In addition to weight loss, Bariatric surgery results in resolution of co-morbid conditions like type 2 diabetes , hypertension, obstructive sleep apnea, hyperlipidemias in significant number of patients. These co-morbid conditions along with central obesity constitute metabolic syndrome. This resolution is more after restrictive + mal-absorptive operations and mostly mal-absorptive operations compared to purely restrictive operations. Reason behind this resolution is thought to be due to the alteration of gut hormones that control insulin production and action, in addition to weight loss and calorie restriction. Due to the positive effect of bariatric surgery on type 2 diabetes , exclusive laparoscopic metabolic surgery is developed. Laparoscopic Sleeve Gastrectomy with Duodenoileal Interposition (Laparoscopic Diverted Sleeve Gastrectomy with Ileal Interposition), Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass and Laparoscopic Sleeve Gastrectomy with Jejunoileal Interposition (Laparoscopic Sleeve Gastrectomy with Ileal Interposition) are the metabolic surgeries. These operations result in resolution of type 2 diabetes in obese patients and even in patients with normal BMI. How Type 2 Diabetes is Cured by Metabolic Surgery? Insulin is a chemical which keeps the blood sugar under control. In metabolic surgery we remove part of stomach (sleeve gastrectomy) and rearrange small bowel. This leads to changes in several gut hormones that control release of insulin and its action. Metabolic surgery cures type 2 diabetes as a result of several factors. Some of them are increased incretins, reduced anti incretins, reduced ghrelin, increased action of leptin, rapid emptying of stomach, ca Continue reading >>

Low Cost Diabetes Surgery In India

Low Cost Diabetes Surgery In India

Plan your Diabetes Surgery in India with Forerunners Healthcare Consultants Diabetes Surgery today ranks among the most performed surgery in India as the number of diabetes patients is increasing rapidly. Medical fraternity in India is highly-skilled to treat the disorder, but it can be tricky for overseas patients to find the right surgeon in India. Forerunners Healthcare Consultants in India is a major medical value provider offering easy access to the best healthcare facilities in India at affordable rates. A patient only has to send us a quick enquiry and the company executive will help through with the procedure. How things function at Forerunners Healthcare Consultants Primary services : We offer assistance in arranging medical visa, provide accommodation for the patient and family, meals, appointment with surgeon. We also provide health diet as advised by the attending surgeon, to and fro airport travel, vacation tour, etc. Comfort : Our company ensures you remain stress-free from the moment you land in India, and all through the procedure, even after your surgery is performed. Communication : We at Forerunners Healthcare Consultants do a detailed study of your needs and send references to respective medical experts accordingly. Be rest assured as the best in field surgeons shall be giving you a new life. Low cost : The overall expenses, including surgeries, stay, meals, medication, flight tickets, for diabetes surgery in India are very much less than most of the countries offering the same state-of-art facilities. Quality care : Forerunners Healthcare Consultants has association with a panel of doctors in India who will never compromise with the efforts in surgery to be performed. International Patient Experience I am Mr Saka from Nigeria. I needed a surgery for Continue reading >>

Metabolic Surgery In The Treatment Algorithm For Type 2 Diabetes: A Joint Statement By International Diabetes Organizations

Metabolic Surgery In The Treatment Algorithm For Type 2 Diabetes: A Joint Statement By International Diabetes Organizations

BACKGROUND Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options. AIM The 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop global guidelines to inform clinicians and policymakers about benefits and limitations of metabolic surgery for T2D. METHODS A multidisciplinary group of 48 international clinicians/scholars (75% nonsurgeons), including representatives of leading diabetes organizations, participated in DSS-II. After evidence appraisal (MEDLINE [1 January 2005–30 September 2015]), three rounds of Delphi-like questionnaires were used to measure consensus for 32 data-based conclusions. These drafts were presented at the combined DSS-II and 3rd World Congress on Interventional Therapies for Type 2 Diabetes (London, U.K., 28–30 September 2015), where they were open to public comment by other professionals and amended face-to-face by the Expert Committee. RESULTS Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to manage T2D. Numerous randomized clinical trials, albeit mostly short/midterm, demonstrate that metabolic surgery achieves excellent glycemic control and reduces cardiovascular risk factors. On the basis of such evidence, metabolic surgery should be recommended to treat T2D in patients with class III obesity (BMI ≥40 kg/m2) and in those with class II obesity (BMI 35.0–39.9 kg/m2) when hyperglycemia is inadequately controlled by lifestyle and optimal medical therapy. Surgery should also be considered for patients with T2D and BMI 30.0–34.9 kg/m2 if hyperglycemia is inadequately controll Continue reading >>

Bariatric Surgery And Diabetes Remission: Who Would Have Thought It?

Bariatric Surgery And Diabetes Remission: Who Would Have Thought It?

Bariatric surgery and diabetes remission: Who would have thought it? We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Bariatric surgery and diabetes remission: Who would have thought it? Awadhesh Kumar Singh, Ritu Singh, and Sunil Kumar Kota Type 2 diabetes mellitus (T2DM) and obesity are increasingly common and major global health problems. The Edmonton obesity staging system clearly pointed towards increased mortality proportionate to the severity of obesity. Obesity itself triggers insulin resistance and thereby poses the risk of T2DM. Both obesity and T2DM have been associated with higher morbidity and mortality and this calls for institution of effective therapies to deal with the rising trend of complications arising out of this dual menace. Although lifestyle changes form the cornerstone of therapy for both the ailments, sustained results from this modalities is far from satisfactory. While Look AHEAD (action for HEAalth in diabetes) study showed significant weight loss, reduction in glycated hemoglobin and higher remission rate of T2DM at 1st year following intensive lifestyle measures; recurrence and relapse rate bounced back in half of subjects at 4 years, thereby indicating that weight loss and glycemic control is difficult to maintain in the long term with lifestyle interventions. Same recurrence phenomenon was also observed with pharmacotherapy with rimonabant, sibutramine and orlistat. Bariatric surgery has been see Continue reading >>

Metabolic Surgery For Diabetes In India

Metabolic Surgery For Diabetes In India

Diabetes is curable by metabolic surgery. It might sound more like a jargon, but this is the most recent update in the medical discovery. It is a story of yesteryear when Type-2 diabetes treatment was synonymous to suppressing it by medication or diet. Balancing blood sugar level was also one more focus in the earlier diabetes treatments. But with metabolic surgery you can say goodbye to diabetes. Whoa!! You read it right. Diabetes has a cure! And the surgery process is named as metabolic surgery. The specification with the surgery is that people with Type-2 diabetes have a higher chance of getting more success from it. The metabolic surgery is though a new phenomenon it is getting popular in its own sphere. Metabolic surgery is used to describe the surgical process to treat Type-2 diabetes. Type-2 Diabetes :your insulin is fooling around Type -2 diabetes is the condition where your body is secreting less insulin to control your blood sugar level. Or your body is secreting insulin but the reception rate of your body is very low. Type-2 diabetes is also known as diabetes mellitus or simply diabetes. Without proper treatment diabetes can cause havoc in a person by leading to blindness, kidney failure, cardiac failure and heart stroke. Metabolic surgery can cure my Type-2 diabetes, but when? If your BMI is lesser than 35 then there is no doubt that your condition is just appropriate for the metabolic surgery. Around 86% of remission of your diabetes mellitus can be done by the metabolic surgery and your death rate can be decreased by 89%. If your BMI is 30-35 and you are obese with many medical complications then you should immediately go for metabolic surgery. The main focus of a metabolic surgery is to handle your hormone, which is responsible for balancing blood sugar Continue reading >>

Diabetes Surgery In India, Metabolic Surgery For Diabetes

Diabetes Surgery In India, Metabolic Surgery For Diabetes

Diabetes mellitus is a chronic disease affecting almost every organ of the body. It might happen either due to decreased production of insulin or increased resistance to insulin in the body. It has emerged in epidemic proportions all over the world. It has become a major health hazard and is the main cause of premature illness, kidney and heart diseases and even blindness, ulcers and amputations, worldwide. The treatment of diabetes involves, lifestyle changes, diet control and certain drugs and insulin therapy. Inspite of best of the treatments, patients do not achieve good glycemic control which results in ongoing and slow damage to blood vessels, kidneys, heart, brain and eyes. These days metabolic surgery for diabetes has emerged as a proven tool for resolution or control of type 2 diabetes. As many as 80% of people suffering from type 2 diabetes have experienced complete resolution of disease after undergoing metabolic surgery. The remaining 20% have experienced benefits in terms of reduction of the amount, quantity and frequency of drugs. There have been reduction in the need for insulin injections as well. There are certain defined criteria which has been identified by international diabetes federation, the largest governing body in the world for Diabetes and related diseases to choose patients who are eligible for this surgery. Other organisations that endorse this surgery are American Heart Association and The American Diabetes Association. This surgery is done laparoscopically (through key holes). There are no drains and bandages in most of the cases. A person is fit to go back home in a day or two post-surgery. There are some special procedures for patients suffering from diabetes which are independent of BMI.Ileal interposition and duodenojejunal bypass are Continue reading >>

Best Metabolic Surgery For Type 2 Diabetes In Mumbai, India | Bestbariatricsurgeon.org

Best Metabolic Surgery For Type 2 Diabetes In Mumbai, India | Bestbariatricsurgeon.org

Every 21 seconds someone is diagnosed with diabetes and diabetes claims 4 million lives every year. While deaths due to heart disease have come down, diabetes has emerged as the leading cause of death in the last few years. Unfortunately, developing nations are bearing the brunt of this disease. There has been a huge progress in the treatment of diabetes in the last few decades. Diet, exercise and medications remain the cornerstone of diabetes therapy but unfortunately only 7.3% patients are able to reach the composite goal of medical therapy with these therapies. Remaining 92.3% patients struggle to meet the goals of treatment despite being on multiple medications which include insulin therapy. There are also many barriers that prevent the patients from reaching their treatment goals. First and foremost is that as the number of drugs in the prescription go up, patient compliance comes down. Some patients are on as many as 10 to 20 drugs that need to be taken on a daily basis. Some of these drugs have many side effects and eventually get banned, a case in point being Avandia which was banned in India a few years ago. Hypoglycemia is another big challenge that is faced by patients on a regular basis. In addition to this as the diabetes progresses, patients need to progress onto taking multiple shots of insulin. This is not only painful but psychologically very demotivating as well. Natural history of type 2 diabetes is such that long term complications of this disease are unavoidable. Long duration diabetes eventually leads to kidney disease, heart disease, eye problems and neuropathy etc. Once these complications set in, it is difficult to reverse the disease process. Metabolic surgery for type 2 diabetes is not a new concept. Almost 60 years ago, some gastro-intestina Continue reading >>

What Is Metabolic Surgery? Diabetes & Weight Loss Treatment

What Is Metabolic Surgery? Diabetes & Weight Loss Treatment

Metabolic syndrome is the name for a group of risk factors that increases the chance of developing heart disease , diabetes and stroke. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome. A large waistline indicating abdominal obesity or "having an apple shape." Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips. A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood. A low HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease. High blood pressure (or you're on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup. High fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes. The treatment of Metabolic Syndrome by surgical methods is called Metabolic Surgery. Experiments were done in the last half of the 20th century to see if diseases like high lipids and cholesterol could be treated with surgical procedures such as intestinal bypass. In 1995, Dr. Walter Pories and his research team published an article titled "Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus". Since that landmark paper, much evidence has been accumulated showing that surgery can cure/imp Continue reading >>

The Advent Of Bariatric Surgery For Diabetes In India

The Advent Of Bariatric Surgery For Diabetes In India

The advent of bariatric surgery for diabetes in India The advent of bariatric surgery for diabetes in India BMJ 2013; 347 doi: (Published 26 July 2013) Cite this as: BMJ 2013;347:f3391 Ron Thomas Varghese, fellow, department of endocrinology, diabetes and metabolism, Christian Medical College, Vellore, India Obesity and diabetes are some of Indias growing problems. Is surgery the answer? And is the market best left to decide? Ron Thomas Varghese reports Economic development in India has led to a shift in disease burden, with a huge increase in non-communicable disease. The prevalence of obesity, for example, has risen even in rural areas. Some 42% of the population in rural Kerala have been reported to be either overweight or obese.1 A study of an urban slum in northern India reported 40% of the women to be obese,2 and the prevalence of obesity among 350 patients attending a clinic for diabetes mellitus in Gujarat was 70%.3 Bariatric surgery is seen as a tool for tackling obesity. Some studies suggest that bariatric surgery could even help to prevent diabetes mellitus, especially in patients who are obese.4 Patients with diabetes often find it difficult to cope with multiple insulin injections. They can feel frustrated when their glycaemic control remains poor despite their best efforts. Their quality of life can decline,5 and a vicious cycle of non-adherence to treatment and poor glycaemic control can set in. The quality of life of obese patients undergoing bariatric surgery is thought to improve as a result of weight loss,6 and many patients perceive bariatric surgery to be a panacea. The number of patients in India undergoing bariatric surgery is rising. The Obesity Surgery Society of India has stated that the number of people having such surgery rose from 2200 in 2 Continue reading >>

Metabolic Surgery India | Obesity & Metabolic Surgery Society Of India

Metabolic Surgery India | Obesity & Metabolic Surgery Society Of India

Home // Obesity Surgery // Bariatric Surgery/Treatment // Metabolic Surgery Diabetes being a medical disease, it was traditionally treated by diet and exercise with mild oral medicines. When this progressed, more drugs were added to control blood sugars; when this went on increasing, insulin injections were added. Diabetes is the cause of cardiac problems and kidney failure in many patients; it is a killer disease with epidemic proportions, in Asia, especially in India. Despite availability of various medicines, over 55% diabetic patients cannot maintain their blood sugar levels below the desired limits (HbA1C below 7), the disease keeps on progressing in most people with on-going complications on many organs in the body. It is associated with high cholesterol levels, high blood pressure, fatty liver disease, obesity and polycystic ovary disease causing the Metabolic Syndrome and also kidney failures, heart attacks, eye problems including blindness, nerve diseases etc. Type 2 diabetes can be a lifelong condition. This is an increasingly widespread health issue in India and has serious long-term consequences. You may want to compare bariatric surgery's high resolution rates to the long-term effects of this condition. Diabetic or Metabolic surgery is surgery for cure of diabetes associated with or without obesity. Metabolic surgery can also be sometimes performed for Hypertension and Dyslipidaemia alone. These type of surgeries are performed for people with uncontrolled levels of blood parameters even after the maximum dose of drugs and has become life threatening. Surgery for diabetes* is to ensure better blood sugar (glycaemic) control for patients with Adult Onset or Type 2 Diabetes Mellitus (T2DM). Gastric Bypass and Bilio-pancreatic diversion resulted in control/ cu Continue reading >>

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