Calorie restriction and not glucagon‐like peptide‐1 explains the acute improvement in glucose control after gastric bypass in Type 2 diabetes
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Aims: To compare directly the impact of glucagon‐like peptide‐1 secretion on glucose metabolism in individuals with Type 2 diabetes listed for Roux‐en‐Y gastric bypass surgery, randomized to be studied before and 7 days after undergoing Roux‐en‐Y gastric bypass or after following a very‐low‐calorie diet. Methods: A semi‐solid meal test was used to investigate glucose, insulin and glucagon‐like peptide‐1 response. Insulin secretion in response to intravenous glucose and arginine stimulus was measured. Hepatic and pancreatic fat content was quantified using magnetic resonance imaging. Results: The decrease in fat mass was almost identical in the Roux‐en‐Y gastric bypass and the very‐low‐calorie diet groups (3.0±0.3 and 3.0±0.7kg). The early rise in plasma glucose level and in acute insulin secretion were greater after Roux‐en‐Y gastric bypass than after a very‐low‐calorie diet; however, the early rise in glucagon‐like peptide‐1 was disproportionately greater (sevenfold) after Roux‐en‐Y gastric bypass than after a very‐low‐calorie diet. This did not translate into a greater improvement in fasting glucose level or area under the curve for glucose. The reduction in liver fat was greater after Roux‐en‐Y gastric bypass (29.8±3.7 vs 18.6±4.0%) and the relationships between weight loss and reduction in liver fat differed between the Roux‐en‐Y gastric bypass group and the very‐low‐calorie diet group. Conclusions: This study shows that gastroenterostomy increases the rate of nutrient absorption, bringing about a commensurately rapid rise in insulin level; however, there was no association with the large post‐meal rise in glucagon‐like peptide‐1, and post‐meal glucose homeostasis was similar in the Roux‐en‐Y gastric bypass and very‐low‐calorie diet groups. (Clinical trials registry number: ISRCTN 11969319.)
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A weight loss of 13.5% after either bariatric surgery or dietary induced weight loss achieves a maximum decrease in liver fat.
“A weight loss of 13.5% after either bariatric surgery or dietary induced weight loss achieves a maximum decrease in liver fat.”
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Self-citation
- Authors
- Steven, S., Hollingsworth, K. G., Small, P. K., Woodcock, S. A., Pucci, A., Aribasala, B., Al‐Mrabeh, A., Batterham, R. L., & Taylor, R.
- Affiliations
- Newcastle University (GB)
- Sunderland Royal Hospital (GB)
- North Tyneside General Hospital (GB)
- University College London (GB)
- Lagos State University (NG)
- Magnetic Resonance Centre Institute of Cellular Medicine, Newcastle University Newcastle upon Tyne UK
- Corresponding author
- Taylor, R.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2016-10-08
- Volume
- 33
- Issue
- 12
- Pages
- 1723-1731
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2511459438
- Cited by
- 71
- References
- 33
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 13 · 2023: 6 · 2022: 4 · 2021: 8 · 2020: 9 · 2019: 10 · 2018: 8 · 2017: 3 · 2012: 1
- FWCI
- 7.75
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- European Foundation for the Study of Diabetes
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- Roux-en-Y gastric bypass, type 2 diabetes, glucagon-like peptide-1, very low calorie diet, caloric restriction, glucose homeostasis, insulin secretion, liver fat, weight loss, bariatric surgery, nutrient absorption
- MeSH terms
- Insulin Secretion, Acyltransferases, Adipose Tissue, Adult, Aged, Amino Acids, Arginine, Blood Glucose, Body Composition, Chromium, Diabetes Mellitus, Type 2, Female, Glucose, Glycated Hemoglobin, Humans, Insulin, Insulin Resistance, Lipase, Liver, Male, Membrane Proteins, Middle Aged, Nicotinic Acids, Pancreas, Triglycerides, Gastric Bypass, Caloric Restriction, Glucagon-Like Peptide 1, Phospholipases A2, Calcium-Independent
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