Effects of gastric bypass and gastric banding on glucose kinetics and gut hormone release
Open accessAbstract
BACKGROUND: Bariatric surgery markedly improves glucose homeostasis in patients with type 2 diabetes even before any significant weight loss is achieved. Procedures that involve bypassing the proximal small bowel, such as Roux-en-Y gastric bypass (RYGBP), are more efficient than gastric restriction procedures such as gastric banding (GB). OBJECTIVE: To evaluate the effects of RYGBP and GB on postprandial glucose kinetics and gastro-intestinal hormone secretion after an oral glucose load. METHODS AND PROCEDURES: This study was a cross-sectional comparison among non-diabetic, weight-stable women who had undergone RYGBP (n = 8) between 9 and 48 months earlier or GB (n = 6) from 25 to 85 months earlier, and weight- and age-matched control subjects (n = 8). The women were studied over 4 h following ingestion of an oral glucose load. Total glucose and meal glucose kinetics were assessed using glucose tracers and plasma insulin, and gut hormone concentrations were simultaneously monitored. RESULTS: Patients who had undergone RYGBP showed a a more rapid appearance of exogenous glucose in the systemic circulation and a shorter duration of postprandial hyperglycemia than patients who had undergone GB and C. The response in RYGBP patients was characterized by early and accentuated insulin response, enhanced postprandial levels of glucagon-like peptide-1 (GLP-1) and polypeptide YY (PYY), and greater postprandial suppression of ghrelin. DISCUSSION: These findings indicate that RYGBP is associated with alterations in glucose kinetics and glucoregulatory hormone secretion. These alterations are probably secondary to the anatomic rearrangement of the foregut, given the fact that they are not observed after GB. Increased PYY and GLP-1 concentrations and enhanced ghrelin suppression are compatible with reduced food intake after RYGBP.
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The relatively higher postprandial insulin responses seen in patients after gastric bypass are not a response to insulin resistance or the result of general hypersensitivity of β-cells to glucose.
“These findings suggest that the relatively higher postprandial insulin responses seen in patients after GB (8,9,12,23) are not a response to insulin resistance or the result of general hypersensitivity of β-cells to glucose.”
From Gastric Bypass Surgery Enhances Glucagon-Like Peptide 1–Stimulated Postprandial Insulin Secretion in Humans (2011) · cites this paper as [12]
Gastric bypass subjects have elevated plasma concentrations of GLP-1.
“GB subjects have elevated plasma concentrations of GLP-1 (6,8–13).”
From Gastric Bypass Surgery Enhances Glucagon-Like Peptide 1–Stimulated Postprandial Insulin Secretion in Humans (2011) · cites this paper as [12]
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Self-citation
- Authors
- Rodieux, F., Giusti, V., D'Alessio, D. A., Suter, M., & Tappy, L.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Tappy, Luc
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2008-02
- Volume
- 16
- Issue
- 2
- Pages
- 298-305
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W2083514058
- Cited by
- 216
- References
- 60
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 10 · 2018: 10 · 2017: 8 · 2016: 11 · 2015: 22 · 2014: 20 · 2013: 22 · 2012: 26
- FWCI
- 24.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- American Diabetes Association
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (DK57900, R01DK057900)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- Roux-en-Y gastric bypass, gastric banding, bariatric surgery, glucose kinetics, postprandial hyperglycemia, gut hormone secretion, glucagon-like peptide-1, ghrelin, insulin response, glucose homeostasis, type 2 diabetes
- MeSH terms
- Adolescent, Adult, Blood Glucose, Cross-Sectional Studies, Eating, Fatty Acids, Nonesterified, Female, Gastrointestinal Hormones, Glucose, Homeostasis, Humans, Insulin, Middle Aged, Gastric Bypass, Case-Control Studies, Peptide YY, Bariatric Surgery, Glucagon-Like Peptide 1, Ghrelin
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