Differential Acute Impacts of Sleeve Gastrectomy, Roux-en-Y Gastric Bypass Surgery and Matched Caloric Restriction Diet on Insulin Secretion, Insulin Effectiveness and Non-Esterified Fatty Acid Levels Among Patients with Type 2 Diabetes

Autor: Greg C. Smith, Grant Beban, Rinki Murphy, Richard Babor, J. Geoffrey Chase, Michael Booth, Jun Lu, Felicity Louise Thomas
Rok vydání: 2016
Předmět:
Adult
Blood Glucose
Male
medicine.medical_specialty
Sleeve gastrectomy
Diet
Reducing
Matched-Pair Analysis
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
food.diet
Gastric Bypass
030209 endocrinology & metabolism
Type 2 diabetes
medicine.disease_cause
03 medical and health sciences
0302 clinical medicine
NEFA
food
Insulin resistance
Gastrectomy
Insulin-Secreting Cells
Internal medicine
Insulin Secretion
Weight Loss
medicine
Humans
Insulin
030212 general & internal medicine
Caloric Restriction
Glucose tolerance test
Nutrition and Dietetics
medicine.diagnostic_test
business.industry
Gastric bypass surgery
Fatty Acids
Glucose Tolerance Test
Middle Aged
medicine.disease
Obesity
Morbid
Very low calorie diet
Endocrinology
Diabetes Mellitus
Type 2
Female
Surgery
Insulin Resistance
business
Zdroj: Obesity Surgery. 26:1924-1931
ISSN: 1708-0428
0960-8923
DOI: 10.1007/s11695-015-2038-3
Popis: Bariatric surgery is an increasingly common option for control of type 2 diabetes (T2D) and obesity. Mechanisms underlying rapid improvement of T2D after different types of bariatric surgery are not clear. Caloric deprivation and altered levels of non-esterified fatty acid (NEFA) have been proposed. This study examines how sleeve gastrectomy (SG), Roux-en-Y gastric bypass (GBP) or matched hypocaloric diet (DT) achieves improvements in T2D by characterising components of the glucose metabolism and NEFA levels before and 3 days after each intervention. Plasma samples at five time points during oral glucose tolerance test (OGTT) from subjects with T2D undergoing GBP (N = 11) or SG (N = 12) were analysed for C-peptide, insulin and glucose before surgery and 3-day post-intervention or after DT (N = 5). Fasting palmitic, linoleic, oleic and stearic acid were measured. C-peptide measurements were used to model insulin secretion rate (ISR) using deconvolution. Subjects who underwent GBP surgery experienced the greatest improvement in glycaemia (median reduction in blood glucose (BG) from basal by 29 % [IQR −57, −18]) and the greatest reduction in all NEFA measured. SG achieved improvement in glycaemia with lower ISR and reduction in all but palmitoleic acid. DT subjects achieved improvement in glycaemia with an increase in ISR, 105 % [IQR, 20, 220] and stearic acid. GBP, SG and DT each improve glucose metabolism through different effects on pancreatic beta cell function, insulin sensitivity and free fatty acids.
Databáze: OpenAIRE
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