GLP-1 and Changes in Glucose Tolerance following Gastric Bypass Surgery in Morbidly Obese Subjects

Morı́nigo, Rosa; Lacy, Antonio M.; Casamitjana, Roser; Delgado, Salvadora; Gomis, Ramón; Vidal, Josep

doi:10.1381/096089206779319338

Cited by 134 publications

(128 citation statements)

References 28 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…Here, a trend towards a less intense weight loss could be noticed in the DM2 group (P = 0.053), which may not have been statistically significant because of the sample's size. This lower weight loss was found in the study by Morínigo et al 10 . Some studies also indicate that post-operative weight loss did not correlate with DM2's PREOP length, but was inversely proportional to the DM2's severity in PREOP 15 .…”

Section: Discussionsupporting

confidence: 58%

Evaluation of weight loss and metabolic profile of obese patients with type 2 diabetes mellitus (dm2) versus non-dm2 subjects, one and three years after bariatric surgery

Napoli

Guzzo

Hisano

et al. 2010

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

-Background -There is a debate over results obtained from type 2 diabetes mellitus (DM2) obese patients and non-DM2 patients, in reference to metabolic control and ponderal loss, after bariatric surgery. Aim -To evaluate weight loss and metabolic profile of obese patients with DM2 versus non-DM2 subjects, one and three years after bariatric surgery. Methods -Data from 38 non-DM2 patients and 44 DM2 patients submitted to Roux-en-Y gastric-bypass were analysed retrospectively. For the preoperatory, first and third year of post-operatory, were compared: weight, body mass index (BMI), fasting glucose (FG), high density lipoprotein (HDL) and triglycerides (TG). Results -Preoperatively, both groups were statistically equivalent in regards to weight, BMI (P = 0.90) and HDL (P = 0.73). This was not the case when TG (P = 0.043) and FG (P<0.01) were analyzed. In PO1, both DM2 and non-DM2 groups showed a reduction in weight, BMI and TG, just as FG in the DM2 group (P < 0.05). HDL increased (P < 0.05) in PO1 in both groups. In the following period, between PO1 and PO3, only TG continued to decrease in the non-DM2 group (P = 0.039), while the other variables did not change. In the DM2 group mean A1c in PO3 was 6.2% +-0.75 (P = 0.027). It was compared both group's postoperative data. HDL's and TG's variation between groups did not differ in PO1 or between PO1 and PO3. Weight in PO1 and PO3, just as BMI in PO1 and PO3, were not significantly different either. Conclusion -In PO1, weight loss and metabolic improvement was seen in both groups. This was sustained in PO3, with no significant weight regain or lipid/FG change. A1c found suggests a reasonable control of DM2 surgery. A trend towards a less intense weight loss could be noticed in the DM2 group (P = 0.053).RESUMO -Racional -Tem havido debate sobre os resultados obtidos da cirurgia bariátrica nos obesos diabéticos versus não diabéticos, no quesito controle metabólico e perda ponderal. Objetivo -Avaliar a perda ponderal e perfil metabólico dos obesos diabéticos e não diabéticos após um e três anos da cirurgia bariátrica. Método -Análise retrospectiva dos prontuários de 44 diabéticos tipo 2 (DM2) e 38 não-DM2 submetidos à gastroplastia com derivação em Y-de-Roux. Dados como peso, índice de massa corpórea (IMC), glicemia de jejum (GJ), lipoproteína de alta densidade (HDL) e triglicérides (TG) foram vistos no pré-operatório, primeiro (PO1) e terceiro ano (PO3) após a operação.Resultados -No pré-operatório, ambos os grupos foram estatisticamente equivalentes em peso, IMC (P=0,90) e HDL (P=0.73). Não se verificou o mesmo quando TG (P=0.043) e GJ (P < 0.01) foram analisados. No PO1, ambos DM2 e não-DM2 mostraram redução no peso, IMC e TG, assim como GJ no grupo DM2 (P < 0.05). HDL aumentou (P < 0.05) no PO1 em ambos os grupos. No período seguinte, entre PO1 e PO3, somente TG continuou a cair nos não-DM2 diabéticos (P=0,039), enquanto as outras variáveis não mudaram. No grupo DM2, a média da A1c no PO3 foi 6,2% +-0,75 (P=0,027).Compararam-se os dados do pós-operatório de...

show abstract

Section: Discussionsupporting

confidence: 58%

Evaluation of weight loss and metabolic profile of obese patients with type 2 diabetes mellitus (dm2) versus non-dm2 subjects, one and three years after bariatric surgery

Napoli

Guzzo

Hisano

et al. 2010

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

show abstract

“…This is the expected consequence of the reduced adipose mass and improved insulin sensitivity (73). In contrast, in type 2 diabetic patients, HOMA of ␤-cell function after LAGB (45), AIR and the insulinogenic index after RYGB (49,52), and AIR after BPD (47) all increased to a variable extent. Model-derived ␤-cell glucose sensitivity was fully normalized in 10 type 2 diabetic patients 2 years post-BPD in parallel with the normalization of daylong plasma glucose concentrations (54).…”

Section: Bariatric Surgery and ␤-Cell Functionmentioning

confidence: 99%

“…It is not clear what the precise mechanism is by which GLP-1 release is revved up by anatomical rearrangements that either bypass the duodenum and upper jejunum (RYGB) or exclude the larger part of the entire gastrointestinal tract from food transit (BPD). However, in one study, GLP-1 at 6 weeks postsurgery was increased in normotolerant and impaired glucose-tolerant subjects but not in type 2 diabetic patients despite similar improvements in insulin resistance and ␤-cell dysfunction (49). Also, infusion of GLP-1 to pharmacological levels fails to stimulate insulin-mediated glucose disposal in healthy volunteers or under experimental conditions where its effects on endogenous insulin release are prevented (as in type 1 diabetic patients) (rev.…”

Section: Mechanismsmentioning

confidence: 99%

Impact of Different Bariatric Surgical Procedures on Insulin Action and β-Cell Function in Type 2 Diabetes

2009

View full text Add to dashboard Cite

“…GLP-1 levels increase after a meal in patients after RY-GBP (27) or with oral glucose after BPD (28). Meal-stimulated GIP levels have been reported to increase after JIB (20) or to decrease after GBP or JIB surgery (23,26,29).…”

mentioning

confidence: 99%

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

et al. 2007

View full text Add to dashboard Cite

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 Ϯ 7.0 kg, oral glucose-stimulated GLP-1 (AUC) and GIP peak levels increased significantly by 24.3 Ϯ 7.9 pmol ⅐ l Ϫ1 ⅐ min Ϫ1 (P Ͻ 0.0001) and 131 Ϯ 85 pg/ml (P ϭ 0.007), respectively. The blunted incretin effect markedly increased from 7.6 Ϯ 28.7 to 42.5 Ϯ 11.3 (P ϭ 0.005) after RY-GBP, at which it time was not different from that for the control subjects (53.6 Ϯ 23.5%, P ϭ 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.

show abstract

GLP-1 and Changes in Glucose Tolerance following Gastric Bypass Surgery in Morbidly Obese Subjects

Abstract: 1) RYGBP was associated with an improvement but not complete restoration of glucose homeostasis at 6 weeks after surgery. 2) GLP-1 is not a critical factor for the early changes in glucose tolerance.

Cited by 134 publications

References 28 publications

Evaluation of weight loss and metabolic profile of obese patients with type 2 diabetes mellitus (dm2) versus non-dm2 subjects, one and three years after bariatric surgery

Evaluation of weight loss and metabolic profile of obese patients with type 2 diabetes mellitus (dm2) versus non-dm2 subjects, one and three years after bariatric surgery

Impact of Different Bariatric Surgical Procedures on Insulin Action and β-Cell Function in Type 2 Diabetes

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

Contact Info

Product

Resources

About