Key points from today’s guests:

Morning Rounds – Updates on the Latest News

Dr. Tim Williamson, physician VP for quality and safety, The University of Kansas Health System

• Recent hurricanes are causing a disruption in the supply chain for many medical supplies, especially IV fluids.
• IV fluids are commonly used throughout the healthcare industry -- inpatient, ambulatory, in the emergency department, surgical center -- so we use them on virtually every healthcare setting that we're in. It’s also used in home healthcare applications.
• This is so much broader than those other supply chain shortages we've had, and we had no forewarning. We know that we can't go out and get more IV fluids because with 60 percent of the market being affected, those other 40 percent are also impacted because of that need to bulk up supplies.
• This may impact certain surgeries. If they're truly elective, we may have to figure out which ones can be pushed back depending on how much IV fluid needs to be used.

Focus Topic

Dr. Steve Stites, chief medical officer, The University of Kansas Health System; executive vice chancellor, The University of Kansas Medical Center

• Many people have battled a weight problem for years. Often, the extra pounds lead to other conditions such as diabetes.
• Research published in the journal the American Medical Association is comparing the two main treatment paths for those who are living with obesity and diabetes.
• The study pulled data from four different randomized control trials looking at hundreds of people with type two diabetes, and its key question was, what's better at getting their glucose under control -- bariatric surgery or medical and lifestyle management?
• According to this study, bariatric surgery achieved much better long-term control of blood sugars compared to people who only received medical management and lifestyle interventions.

Dr. Jennifer McAllister, bariatric surgeon, The University of Kansas Health System

• We've known for years that bariatric surgery is effective for weight loss and this study adds to our knowledge that it's a very effective treatment for diabetes -- and not only diabetes, but also high cholesterol, hypertension, sleep apnea, risk factors for cardiovascular disease and also decreases the incidence of cancer in post bariatric patients.
• With GLP-1 drugs, remember that these are fairly new medications, especially indicated for both diabetes, but then separate indications for weight loss.
• What we know with the bariatric operations is that we see a natural increase in our body's own GLP-1 after surgery, with food entering the small intestine more rapidly, we have what's called enhanced nutrient sensing that increases our body's GLP-1.
• It's all of those changes that we now understand much more thoroughly that really help us see the enhanced benefits from bariatric surgery.
• Bariatric surgery is safe and effective. They're now done in a minimally invasive format, where patients usually stay one night in the hospital, sometimes less than that.
• There’s not necessarily one operation that is right for every single patient. It’s really each individual patient’s health history and risk factors that can determine which type of bariatric surgery to have.
• The best part of the job is seeing how patients have a new lease on life, the activities they're able to do with their family, friends, children, and grandchildren.

Lasha Haynes, bariatric surgery patient

• She was 377 pounds before bariatric surgery and she is now down to 188 pounds over a span of 15 months.
• She said it changed her day-to-day activity. When she had the weight on, she could not get around and had trouble breathing. She was also in and out of the hospital due to diabetes.
• Lasha finally wanted to make a change and she found Dr. McAllister to help her.
• She had a gastric bypass surgery, but there are different kinds of weight loss surgeries.
• She has changed her entire eating habits, eliminating junk foods from her diet.
• Lasha encourages others to go for it and get the help they need to change their life.

Dr. John Thyfault, Ph.D., director, KU Diabetes Institute; co-co-principal investigator, KC-MORE

• Lasha’s outcome is pretty typical for patients who undergo bariatric surgery.
• The data shows significant weight loss and weight loss maintenance over time, so it is successful for most people.
• I think it's pretty clear that the degree of weight loss and the maintenance of the weight loss is far better with bariatric surgery, and so it has a more profound effect on glycemic control within diabetes.
• But many times our lifestyle interventions for people with diabetes through clinical care are not that robust, so I think we could do better there.
• We need to destigmatize obesity treatment and get more people coming to the table to either try the new drugs, lifestyle interventions, or surgery. It needs to be talked about more.
• More people don't need to be living with these conditions and putting themselves at risk long term.

Infectious Disease Updates

Dr. Dana Hawkinson, medical director, Infection Prevention & Control, The University of Kansas Health System

• We are keeping an eye on the news about a patient in Missouri who tested positive for avian flu, but did not have any known contact with animals.
• That patient was sent home and is doing well, but there are questions about why the patient was hospitalized and how the patient was infected.
• Further testing is underway. They are creating a special antibody test so they can make sure that they identify only avian flu if they were exposed.

Thursday, Oct. 10 at 8 a.m. is the next All Things Heart. We’ll show you how the newest technology combined with advanced skills is making a difference for heart patients.

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