In view of the raised amylase result and the likelihood of pancreatitis that may be associated with GLP-1 analogue treatment, the medication was stopped and she was regularly followed- up in the Diabetes Clinic. While the primary pharmacological actions of GLP-1 agonists are antihyperglycaemic effect and weight reduction, these drugs may influence other neural and hormonal processes. One of the things from my point of view that we struggle with, in terms of trying to understand these medications, is the effect on the kidney. One of the potential negative effects of a lockdown are changes in dietary and lifestyle patterns, which can lead to weight gain. Marcella Ranieri (RDN, LD, CLC) is a dietitian who believes that small changes can make a big impact! Introduction: Gastric bypass surgery in obese patients results in weight loss, changes in gastrointestinal and pancreatic hormones and improvement of insulin sensitivity. Glycaemia (mmol/l; glucose oxidase);GLP-1 (Active 7–36) (pM/l; ELISA, ALPCO diagnostics) and insulin (ECLIA, Roche Diagnostics, pmol/l) were determined in 49 obese patients (age: 37.8±1.6; BMI: 43.45±0.77 kg/m2) in 4 separate days in 0, 15, 30, 45, 60, 90 and 120 min. Methods: GLP-1, insulin and glucose levels were measured after test meal (Fresubin drink a 200 ml; 200 kcal, 15% protein, 30% fat and 55% carbohydrate) before (day 0) and 5, 90 and 180 days after gastric bypass surgery.

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