Incretin Levels and Effect Are Markedly Enhanced 1 Month After Roux-en-Y Gastric Bypass Surgery in Obese Patients With Type 2 Diabetes  

Oleh:

Laferrère, Blandine ; Heshka, Stanley ; Wang, Krystle ; McGinty, James ; Teixeira, Julio ; Hart, Allison B.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 30 no. 07 (Jul. 2007), page 1709.
Topik: Clinical Care; Education; Nutrition

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2007.03 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

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.

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