Incretin levels and effect are markedly enhanced 1 month after Roux-en-Y gastric bypass surgery in obese patients with type 2 diabetes
| Autor: | Julio Teixeira, Blanca Oliván, Allison B. Hart, Yasmin Khan, Blandine Laferrère, Stanley Heshka, Krystle Wang, James McGinty |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
endocrine system medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastric Bypass Incretin Type 2 diabetes Gastric Inhibitory Polypeptide medicine.disease_cause Article Weight loss Glucagon-Like Peptide 1 Diabetes mellitus Internal medicine Internal Medicine medicine Glucose test Humans Insulin Obesity Postoperative Period Advanced and Specialized Nursing medicine.diagnostic_test Gastric bypass surgery business.industry Middle Aged medicine.disease Glucagon-like peptide-1 Endocrinology Diabetes Mellitus Type 2 Female Laparoscopy medicine.symptom business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Diabetes care. 30(7) |
| ISSN: | 1935-5548 |
| Popis: | OBJECTIVE— Limited data on patients undergoing Roux-en-Y gastric bypass surgery (RY-GBP) suggest that an improvement in insulin secretion after surgery occurs rapidly and thus may not be wholly accounted for by weight loss. We hypothesized that in obese patients with type 2 diabetes the impaired levels and effect of incretins changed as a consequence of RY-GBP.RESEARCH DESIGN AND METHODS— Incretin (gastric inhibitory peptide [GIP] and glucagon-like peptide-1 [GLP-1]) levels and their effect on insulin secretion were measured before and 1 month after RY-GBP in eight obese women with type 2 diabetes and in seven obese nondiabetic control subjects. The incretin effect was measured as the difference in insulin secretion (area under the curve [AUC]) in response to an oral glucose tolerance test (OGTT) and to an isoglycemic intravenous glucose test.RESULTS— Fasting and stimulated levels of GLP-1 and GIP were not different between control subjects and patients with type 2 diabetes before the surgery. One month after RY-GBP, body weight decreased by 9.2 ± 7.0 kg, oral glucose-stimulated GLP-1 (AUC) and GIP peak levels increased significantly by 24.3 ± 7.9 pmol · l−1 · min−1 (P < 0.0001) and 131 ± 85 pg/ml (P = 0.007), respectively. The blunted incretin effect markedly increased from 7.6 ± 28.7 to 42.5 ± 11.3 (P = 0.005) after RY-GBP, at which it time was not different from that for the control subjects (53.6 ± 23.5%, P = 0.284).CONCLUSIONS— These data suggest that early after RY-GBP, greater GLP-1 and GIP release could be a potential mediator of improved insulin secretion. |
| Databáze: | OpenAIRE |
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