The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.
Acute effects of gastric bypass versus gastric restrictive surgery on β-cell function and insulinotropic hormones in severely obese patients with type 2 diabetes
Open accessAbstract
Context:Hyperglycemia resolves quickly after bariatric surgery, but the underlying mechanism and the most effective type of surgery remains unclear.Objective:To examine glucose metabolism and β-cell function in patients with type 2 diabetes mellitus (T2DM) after two types of bariatric intervention; Roux-en-Y gastric bypass (RYGB) and gastric restrictive (GR) surgery.Design:Prospective, nonrandomized, repeated-measures, 4-week, longitudinal clinical trial.Patients:In all, 16 T2DM patients (9 males and 7 females, 52±14 years, 47±9 kg m−2, HbA1c 7.2±1.1%) undergoing either RYGB (N=9) or GR (N=7) surgery.Outcome measures:Glucose, insulin secretion, insulin sensitivity at baseline, and 1 and 4 weeks post-surgery, using hyperglycemic clamps and C-peptide modeling kinetics; glucose, insulin secretion and gut-peptide responses to mixed meal tolerance test (MMTT) at baseline and 4 weeks post-surgery.Results:At 1 week post-surgery, both groups experienced a similar weight loss and reduction in fasting glucose (P<0.01). However, insulin sensitivity increased only after RYGB, (P<0.05). At 4 weeks post-surgery, weight loss remained similar for both groups, but fasting glucose was normalized only after RYGB (95±3 mg 100 ml−1). Insulin sensitivity improved after RYGB (P<0.01) and did not change with GR, whereas the disposition index remained unchanged after RYGB and increased 30% after GR (P=0.10). The MMTT elicited a robust increase in insulin secretion, glucagon-like peptide-1 (GLP-1) levels and β-cell sensitivity to glucose only after RYGB (P<0.05).Conclusion:RYGB provides a more rapid improvement in glucose regulation compared with GR. This improvement is accompanied by enhanced insulin sensitivity and β-cell responsiveness to glucose, in part because of an incretin effect.
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Metadata
- Authors
- Kashyap, S. R., Daud, S., Kelly, K. R., Gastaldelli, A., Win, H., Brethauer, S., Kirwan, J. P., & Schauer, P. R.
- Venue
- International Journal of Obesity
- Published
- 2009-12-22
- Volume
- 34
- Issue
- 3
- Pages
- 462-471
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2032773959
- Cited by
- 274
- References
- 12
- FWCI
- 22.14
- Type
- journal article
- Language
- en
- Open access
- green
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