Glucagon‐like peptide‐1 effect on β‐cell function varies according to diabetes remission status after Roux‐en‐Y gastric bypass

Autor: Ankit Shah, Malini Prasad, Victoria Mark, Jens Juul Holst, Blandine Laferrère
Rok vydání: 2022
Předmět:
Zdroj: Diabetes, Obesity and Metabolism. 24:2081-2089
ISSN: 1463-1326
1462-8902
DOI: 10.1111/dom.14793
Popis: The contribution of endogenous glucagon-like peptide (GLP)-1 to β-cell function after Roux-en-Y gastric bypass surgery (RYGB) is well established in normoglycaemic individuals, but not in those with postoperative hyperglycaemia. We, therefore, studied the effect of GLP-1 on β-cell function in individuals with varying degrees of type 2 diabetes mellitus (T2D) control after RYGB.Glucose, insulin secretion rates, β-cell glucose sensitivity and glucagon were measured during an oral glucose tolerance test before (saline only) and at 3, 12 and 24 months after RYGB with and without infusion of the GLP-1 receptor blocker exendinEX9 blunted the increase in β-cell glucose sensitivity at 3 months (-44.1%, p .001) and 12 months (-43.3%, p .001), but not at 24 months (-12.4%, p = .243). EX9 enhanced postprandial glucagon concentrations by 62.0% at 3 months (p = .008), 46.5% at 12 months (p = .055), and 30.4% at 24 months (p = .017). EX9 counterintuitively decreased glucose concentrations at 3 months in the entire cohort (p .001) but had no effect on glycaemia at 12 and 24 months in persistent T2D and impaired glucose tolerance; it minimally worsened glycaemia in REM at 12 months.GLP-1 blockade reversed the improvement in β-cell function observed after RYGB, but this effect varied temporally and by REM status. GLP-1 blockade transiently and minimally worsened glycaemia only in REM, and lowered postprandial glucose values at 3 months, regardless of REM status.
Databáze: OpenAIRE
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