Related Experiment Video
Updated: May 29, 2026
05:16
Sleeve Gastrectomy in Mice using Surgical Clips
Published on: November 14, 2020
Metformin after bariatric surgery--an acid problem
J Aberle1, F Reining, V Dannheim
1Universitätsklinikum Hamburg-Eppendorf, Sektion Endokrinologie und Diabetologie, Interdisziplinäres Adipositaszentrum, Hamburg. aberle@uke.de
Summary
Metformin use after bariatric surgery requires careful consideration. Elevated ketone bodies post-surgery may increase the risk of lactic acidosis, necessitating a re-evaluation of this common diabetes medication.
Area of Science:
- Endocrinology
- Metabolic Surgery
- Pharmacology
Background:
- Metformin is a first-line oral medication for type 2 diabetes.
- Many patients with type 2 diabetes undergo bariatric surgery and continue Metformin treatment.
- Metformin use is linked to a risk of lactic acidosis.
Purpose of the Study:
- To investigate ketone body levels in patients after bariatric surgery.
- To assess the potential implications of Metformin use in the context of post-bariatric surgery metabolic changes.
Main Methods:
- Ketone bodies were measured in 90 patients.
- Measurements were taken between 5 days and 18 months post-bariatric surgery.
Main Results:
- Ketone bodies were significantly elevated in patients during the initial 3-4 months following bariatric surgery.
- This elevation indicates a phase of negative energy balance and ketone body formation.
Conclusions:
- Metformin use should be critically re-evaluated in patients after bariatric surgery.
- The heightened ketone levels in the early post-operative period may increase the risk associated with Metformin therapy.
Related Concept Videos
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
01:25Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
01:19Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...
Acarbose and miglitol are typically...
01:23Dipeptidyl Peptidase 4 Inhibitors
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a significant...
01:31Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids
In the complex environment of the gastric lumen, excessive acid secretion can lead to the formation or worsening of ulcers within the delicate mucosal layer. Antacids, such as sodium bicarbonate and calcium carbonate, provide relief by neutralizing this acid, transforming it into harmless salt and water. This neutralization process raises the gastric pH from a highly acidic level of 1 to a more basic 3-4, reducing the acidity within the stomach.
However, this neutralization reaction between...
However, this neutralization reaction between...
01:25Diabetic Ketoacidosis l: Introduction
DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...