Restoration of high-frequency glucose-entrained insulin oscillations in obese subjects with type 2 diabetes after biliopancreatic diversion
| Autor: | Angeliki Leonardou, Fotis Kalfarentzos, Christos Argyropoulos, Theodore K. Alexandrides, George Nikiforidis, Christopher Karystianos |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Blood Glucose Male 0301 basic medicine endocrine system medicine.medical_specialty endocrine system diseases medicine.medical_treatment 030209 endocrinology & metabolism Type 2 diabetes Body Mass Index 03 medical and health sciences 0302 clinical medicine Weight loss Insulin-Secreting Cells Internal medicine Weight Loss medicine Humans Insulin Prospective Studies Infusions Intravenous Biliopancreatic Diversion Postoperative Care business.industry nutritional and metabolic diseases Fasting Glucose Tolerance Test medicine.disease Obesity Morbid Surgery Insulin oscillation Sample entropy Glucose 030104 developmental biology Endocrinology Diabetes Mellitus Type 2 Case-Control Studies Sweetening Agents Female Obese subjects Insulin Resistance medicine.symptom business Body mass index |
| Zdroj: | Surgery for Obesity and Related Diseases. 12:1539-1547 |
| ISSN: | 1550-7289 |
| DOI: | 10.1016/j.soard.2016.04.009 |
| Popis: | Background Minimal glucose infusions are known to entrain insulin oscillations in patients with normal glucose tolerance (NGT) but not in patients with type 2 diabetes (T2D). Objectives To investigate whether weight loss after a version of biliopancreatic diversion (BPD) can restore the glucose entrainment of high-frequency insulin oscillations in morbidly obese NGT or T2D patients. Setting University Hospital, Greece. Methods We prospectively studied 9 NGT controls (body mass index [BMI] 23.3±1.6 kg/m 2 ), 9 obese NGT patients (BMI 51.1±12.7 kg/m 2 ), and 9 obese T2D patients (BMI 56.8±11.6 kg/m 2 ). Patients were studied before and 1.5 years after BPD. Insulin was sampled every minute for 90 minutes. Glucose (6 mg/kg weight) was infused every 10 minutes for 1 minute. Regularity of insulin pulses was estimated by autocorrelation analysis, spectral analysis, approximate entropy/sample entropy (ApEn/SampEn), and insulin pulsatility by deconvolution analysis. Results Postoperatively, glucose and insulin concentrations of NGT and T2D patients decreased to control levels and BMI to 31.3±6.3 for NGT patients and 34.9±9.9 kg/m 2 for T2D patients. Preoperatively, glucose entrainment was absent in all T2D and in 4 NGT patients as assessed with spectral analysis and in 8 and 4, respectively, as assessed with autocorrelation and deconvolution analysis. Postoperatively, it was restored to normal in all patients. ApEn/SampEn decreased significantly only in the T2D group postoperatively. Conclusion BPD restores the glucose entrainment of high-frequency insulin oscillations in obese NGT and T2D patients after marked weight loss and normalizes glucose levels and insulin sensitivity, thus demonstrating recovery of β-cell glucose sensing. |
| Databáze: | OpenAIRE |
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