Gastric Emptying of Orally Administered Glucose Solutions and Incretin Hormone Responses Are Unaffected by Laparoscopic Adjustable Gastric Banding

Usinger, Lotte; Hansen, Katrine Bagge; Kristiansen, Viggo B.; Larsen, Steen; Holst, Jens J.; Knop, Filip K.

doi:10.1007/s11695-011-0362-9

Cited by 29 publications

(47 citation statements)

References 41 publications

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“…Six studies have shown that GLP-1 is not increased after medical weight loss and may be decreased (54, 55, 71, 87–90). Only 1 of 10 studies in AGB showed an increase in GLP-1, and in that one study it was increased less than RYGB (30); the others showed no change (8, 21, 22, 56, 57, 68, 91–93). Every malabsorptive procedure exhibits an increase in GLP-1 (for a discussion of the impact of bile acids on GLP-1, see the section below).…”

Section: Resultsmentioning

confidence: 94%

Metabolic surgery: Action via hormonal milieu changes, changes in bile acids or gut microbiota? A summary of the literature

Sweeney

Morton

2014

Best Practice & Research Clinical Gastroenterology

107

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Obesity and type 2 diabetes remain epidemic problems. Different bariatric surgical techniques causes weight loss and diabetes remission to varying degrees. The underlying mechanisms of the beneficial effects of bariatric surgery are complex, and include changes in diet and behavior, as well as changes in hormones, bile acid flow, and gut bacteria. We summarized the effects of multiple different bariatric procedures, and their resulting effects on several hormones (leptin, ghrelin, adiponectin, glucagon-like peptide 1 (GLP-1), peptide YY, and glucagon), bile acid changes in the gut and the serum, and resulting changes to the gut microbiome. As much as possible, we have tried to incorporate multiple studies to try to explain underlying mechanistic changes. What emerges from the data is a picture of clear differences between restrictive and metabolic procedures. The latter, in particular the roux-en-Y gastric bypass, induces large and distinctive changes in most measured fat and gut hormones, including early and sustained increase in GLP-1, possible through intestinal bile acid signaling. The changes in bile flow and the gut microbiome are causally inseparable so far, but new studies show that each contributes to the effects of weight loss and diabetes resolution.

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Section: Resultsmentioning

confidence: 94%

Metabolic surgery: Action via hormonal milieu changes, changes in bile acids or gut microbiota? A summary of the literature

Sweeney

Morton

2014

Best Practice & Research Clinical Gastroenterology

107

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“…However, tracer studies have shown faster exogenous glucose absorption into the systemic circulation after RYGBP compared with AGB, 27 most likely reflecting gastric emptying is accelerated after RYGBP. 28,29 Admittedly, SG has also been associated with accelerated gastric emptying of liquid and semisolid meals. 17 It is tempting to speculate that preservation of the pylorus as in SG-operated subjects would account for the less pronounced postprandrial glycemic peak after this surgical technique compared with RYGBP.…”

Section: Discussionmentioning

confidence: 99%

Remission of Type 2 Diabetes After Roux-en-Y Gastric Bypass or Sleeve Gastrectomy Is Associated With a Distinct Glycemic Profile

et al. 2015

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“…Gastric emptying in individuals with an intact GI tract is tightly regulated [31, 32] due in part to feedback from small intestinal signals activated by luminal nutrients [31]. While gastric banding seems to have no effect on nutrient emptying [33], GB and SG are associated with an increased pace of nutrient passage through the gastric pouch/stomach into the small intestine [34, 35]. Emptying of the stomach pouch in individuals after GB is about 2–3 times faster than that in non-surgical healthy controls for both liquid and solid markers [36].…”

Section: Weight-loss Independent Glycemic Effect Of Bariatric Surgeriesmentioning

confidence: 99%

Effects of glucagon like peptide-1 to mediate glycemic effects of weight loss surgery

Salehi

D’Alessio

2014

Rev Endocr Metab Disord

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To date, weight loss surgeries are the most effective treatment for obesity and glycemic control in patients with type 2 diabetes. Roux-en-Y gastric bypass surgery (RYGB) and sleeve gastrectomy (SG), two widely used bariatric procedures for the treatment of obesity, induce diabetes remission independent of weight loss while glucose improvement after adjustable gastric banding (AGB) is proportional to the amount of weight loss. The immediate, weight-loss independent glycemic effect of gastric bypass has been attributed to postprandial hyperinsulinemia and an enhanced incretin effect. The rapid passage of nutrients into the intestine likely accounts for significantly enhanced glucagon like-peptide 1 (GLP-1) secretion, and postprandial hyperinsulinemia after GB is typically attributed to the combined effects of elevated glucose and GLP-1. For this review we focus on the beneficial effects of the three most commonly performed bariatric procedures, RYGB, SG, and AGB, on glucose metabolism and diabetes remission. Central to this discussion will be the extent to which the effects of surgery are mediated by GLP-1. Better understanding of these mechanisms could provide insight to development of novel therapeutic strategies for treatment of diabetes as well as refinement of surgical techniques.

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Gastric Emptying of Orally Administered Glucose Solutions and Incretin Hormone Responses Are Unaffected by Laparoscopic Adjustable Gastric Banding

Abstract: OGTT can be used to evaluate glucose tolerance in obese patients before and after LAGB without bias from changes in gastric emptying. LAGB has no direct impact on incretin hormone secretion.

Cited by 29 publications

References 41 publications

Metabolic surgery: Action via hormonal milieu changes, changes in bile acids or gut microbiota? A summary of the literature

Metabolic surgery: Action via hormonal milieu changes, changes in bile acids or gut microbiota? A summary of the literature

Remission of Type 2 Diabetes After Roux-en-Y Gastric Bypass or Sleeve Gastrectomy Is Associated With a Distinct Glycemic Profile

Effects of glucagon like peptide-1 to mediate glycemic effects of weight loss surgery

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