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Effect of Weight Loss by Gastric Bypass Surgery Versus Hypocaloric Diet on Glucose and Incretin Levels in Patients with Type 2 Diabetes
Open accessAbstract
CONTEXT: Gastric bypass surgery (GBP) results in rapid weight loss, improvement of type 2 diabetes (T2DM), and increase in incretins levels. Diet-induced weight loss also improves T2DM and may increase incretin levels. OBJECTIVE: Our objective was to determine whether the magnitude of the change of the incretin levels and effect is greater after GBP compared with a low caloric diet, after equivalent weight loss. DESIGN AND METHODS: Obese women with T2DM studied before and 1 month after GBP (n = 9), or after a diet-induced equivalent weight loss (n = 10), were included in the study. Patients from both groups were matched for age, body weight, body mass index, diabetes duration and control, and amount of weight loss. SETTING: This outpatient study was conducted at the General Clinical Research Center. MAIN OUTCOME MEASURES: Glucose, insulin, proinsulin, glucagon, gastric inhibitory peptide (GIP), and glucagon-like peptide (GLP)-1 levels were measured after 50-g oral glucose. The incretin effect was measured as the difference in insulin levels in response to oral and to an isoglycemic iv glucose load. RESULTS: At baseline, none of the outcome variables (fasting and stimulated values) were different between the GBP and diet groups. Total GLP-1 levels after oral glucose markedly increased six times (peak:17 +/- 6 to 112 +/- 54 pmol/liter; P < 0.001), and the incretin effect increased five times (9.4 +/- 27.5 to 44.8 +/- 12.7%; P < 0.001) after GBP, but not after diet. Postprandial glucose levels (P = 0.001) decreased more after GBP. CONCLUSIONS: These data suggest that early after GBP, the greater GLP-1 and GIP release and improvement of incretin effect are related not to weight loss but rather to the surgical procedure. This could be responsible for better diabetes outcome after GBP.
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“Previous studies have established that the incretin effect, β-cell secretion activated by eating, is increased in GB patients with type 2 diabetes (6,9).”
From Gastric Bypass Surgery Enhances Glucagon-Like Peptide 1–Stimulated Postprandial Insulin Secretion in Humans (2011) · cites this paper as [9]
In the citing paper
“Previous studies have reported that glucagon secretion after GB is elevated after meal ingestion (9,16,25)”
From Gastric Bypass Surgery Enhances Glucagon-Like Peptide 1–Stimulated Postprandial Insulin Secretion in Humans (2011) · cites this paper as [9]
In the citing paper
“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 [9]
In the citing paper
“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 [9]
In the citing paper
“this obesity-independent hypoglycemic effect has been related to the action of GLP-1 in promoting insulin section [3], [6].”
From Treatment of obesity and diabetes using oxytocin or analogs in patients and mouse models (2013) · cites this paper as [6]
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BackgroundInterdisciplinary European Guidelines on Metabolic and Bariatric Surgery
Fried, M., Yumuk, V., Oppert, J., Scopinaro, N., Torres, A., Weiner, R. A., Yashkov, Y. I., & Frühbeck, G. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1079-8 · Cited by 768
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Bariatric surgery: an IDF statement for obese Type 2 diabetes
Dixon, J. B., Zimmet, P., Alberti, K. G. M. M., Rubino, F., & on behalf of the International Diabetes Federation Taskforce on Epidemiology and Prevention (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03306.x · Cited by 497
Biology's response to dieting: the impetus for weight regain
MacLean, P. S., Bergouignan, A., Cornier, M., & Jackman, M. R. (2011) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00755.2010 · Cited by 471
Hormonal and Metabolic Mechanisms of Diabetes Remission after Gastrointestinal Surgery
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Mechanick, J. I., Youdim, A., Jones, D. B., Garvey, W. T., Hurley, D. L., McMahon, M. M., Heinberg, L. J., Kushner, R., Adams, T. D., Shikora, S., et al. (2013) · Endocrine Practice · doi:10.4158/ep12437.gl · Cited by 395
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“In obese subjects with T2DM, weight loss induced by GBP, but not by diet intervention, results in recovery of early-phase insulin release after an oral glucose load and a greater reduction of postprandial plasma glucose concentrations (2).”
InfluentialMetabolic Surgery to Treat Type 2 Diabetes: Clinical Outcomes and Mechanisms of Action
Rubino, F., Schauer, P. R., Kaplan, L. M., & Cummings, D. E. (2010) · Annual Review of Medicine · doi:10.1146/annurev.med.051308.105148 · Cited by 391
“(89) showed that after equivalent weight loss of ∼9.”
BackgroundMechanisms of diabetes improvement following bariatric/metabolic surgery
Batterham, R. L., & Cummings, D. E. (2016) · Diabetes Care · doi:10.2337/dc16-0145 · Cited by 376
“exendin(9-39) responsiveness than asymptomatic patients after RYGB (42).”
BackgroundMethodResultInfluentialEffects of GLP-1 on appetite and weight
Shah, M., & Vella, A. (2014) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-014-9289-5 · Cited by 352
“Post-prandial GLP-1 concentrations are increased following Roux-en-Y gastric bypass, an observation that has fuelled interest in investigating the role of GLP-1 in mediating weight loss and remission of metabolic derangements following surgery [32-34]”
BackgroundShah, S. H., Crosslin, D. R., Haynes, C. S., Nelson, S. C., Turer, C. B., Stevens, R. D., Muehlbauer, M. J., Wenner, B. R., Bain, J. R., Laferrère, B., et al. (2011) · Diabetologia · doi:10.1007/s00125-011-2356-5 · Cited by 349
“Detailed methods have been described [6].”
Jacobsen, S. H., Olesen, S. C., Dirksen, C., Jørgensen, N. B., Bojsen-Møller, K. N., Kielgast, U., Worm, D., Almdal, T., Naver, L. S., Hvolris, L. E., et al. (2012) · Obesity Surgery · doi:10.1007/s11695-012-0621-4 · Cited by 342
“ing postprandial GIP responses within the first month after bypass [8–10, 42], although increased [43, 47] as well as decreased [4] peak GIP concentrations during a meal have”
BackgroundMethodResultInfluentialThe environment within: how gut microbiota may influence metabolism and body composition
Vrieze, A., Holleman, F., Zoetendal, E. G., de Vos, W. M., Hoekstra, J. B. L., & Nieuwdorp, M. (2010) · Diabetologia · doi:10.1007/s00125-010-1662-7 · Cited by 358
Korner, J., Inabnet, W., Febres, G., Conwell, I. M., McMahon, D. J., Salas, R., Taveras, C., Schrope, B., & Bessler, M. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.79 · Cited by 338
Poirier, P., Cornier, M.-A., Mazzone, T., Stiles, S., Cummings, S., Klein, S., McCullough, P. A., Ren Fielding, C., & Franklin, B. A. (2011) · Circulation · doi:10.1161/cir.0b013e3182149099 · Cited by 339
Salehi, M., Prigeon, R. L., & D’Alessio, D. A. (2011) · Diabetes · doi:10.2337/db11-0203 · Cited by 323
“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 b-cells to glucose.”
BackgroundInterdisciplinary European Guidelines on Metabolic and Bariatric Surgery
Fried, M., Yumuk, V., Oppert, J., Scopinaro, N., Torres, A. J., Weiner, R. A., Yashkov, Y. I., & Frühbeck, G. (2013) · Obesity Facts · doi:10.1159/000355480 · Cited by 325
Mechanisms of changes in glucose metabolism and bodyweight after bariatric surgery
Madsbad, S., Dirksen, C., & Holst, J. J. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(13)70218-3 · Cited by 307
Bariatric surgery for type 2 diabetes
Dixon, J. B., le Roux, C. W., Rubino, F., & Zimmet, P. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60401-2 · Cited by 299
Chambers, A. P., Jessen, L., Ryan, K. K., Sisley, S. R., Wilson, H., Stefater, M. A., Gaitonde, S. G., Sorrell, J. E., Toure, M. H., Berger, J., et al. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.05.050 · Cited by 289
Jørgensen, N. B., Dirksen, C., Bojsen-Møller, K. N., Jacobsen, S. H., Worm, D., Hansen, D. L., Kristiansen, V. B., Naver, L., Madsbad, S., & Holst, J. J. (2013) · Diabetes · doi:10.2337/db13-0022 · Cited by 282
“This was accomplished by pharmacologically blocking the GLP-1 receptor (GLP-1R) during a liquid meal tolerance test before and after surgery using exendin(9-39) (Ex-9; Bachem AG, Bubendorf, Switzerland), a specific GLP-1R antagonist (16).”
BackgroundMethodRegulation of Glucose Homeostasis by GLP-1
Nadkarni, P., Chepurny, O. G., & Holz, G. G. (2014) · Progress in Molecular Biology and Translational Science · doi:10.1016/b978-0-12-800101-1.00002-8 · Cited by 287
Metabolic Effects of Bariatric Surgery in Patients With Moderate Obesity and Type 2 Diabetes
Kashyap, S. R., Bhatt, D. L., Wolski, K., Watanabe, R. M., Abdul‐Ghani, M. A., Abood, B., Pothier, C. E., Brethauer, S. A., Nissen, S. E., Gupta, M. K., et al. (2013) · Diabetes Care · doi:10.2337/dc12-1596 · Cited by 286
All Bariatric Surgeries Are Not Created Equal: Insights from Mechanistic Comparisons
Stefater, M. A., Wilson, H., Chambers, A. P., Sandoval, D. A., & Seeley, R. J. (2012) · Endocrine Reviews · doi:10.1210/er.2011-1044 · Cited by 289
The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones
Meek, C. L., Lewis, H. B., Reimann, F. M., Gribble, F. M., & Park, A. J. (2015) · Peptides · doi:10.1016/j.peptides.2015.08.013 · Cited by 276
Jackness, C., Karmally, W., Febres, G., Conwell, I. M., Ahmed, L., Bessler, M., McMahon, D. J., & Körner, J. (2013) · Diabetes · doi:10.2337/db12-1762 · Cited by 272
“In this vein, it has been noted that b-cell function (15) and clinical outcome after RYGB (14) are better than equivalent weight loss achieved by LCD; however, the caloric intake and duration of the weight loss periods were greater in the diet groups of both studies.”
BackgroundResultRibaric, G., Buchwald, J. N., & McGlennon, T. W. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1160-3 · Cited by 274
“Preclinical [28] and clinical evidence [19, 29, 30] suggest that improved glycemic control is not linked exclusively with baseline weight or operative weight loss and results from complementary processes [15, 22, 31–33].”
BackgroundThe importance of the gut microbiota after bariatric surgery
Aron‐Wisnewsky, J., Dore, J. M., & Clément, K. (2012) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2012.161 · Cited by 271
Bojsen-Møller, K. N., Dirksen, C., Jørgensen, N. B., Jacobsen, S. H., Serup, A. K., Albers, P. H., Hansen, D. L., Worm, D., Naver, L., Kristiansen, V. B., et al. (2013) · Diabetes · doi:10.2337/db13-1307 · Cited by 253
“Furthermore, several studies have reported comparable changes in HOMA-IR after RYGB and calorie restriction (7,13,15,22,35,36), although a few studies found larger improvements in HOMA-IR after RYGB than after restrictive surgery (37,38) or diet alone (38,39).”
BackgroundResultBlockade of Glucagon-like Peptide 1 Receptor Corrects Postprandial Hypoglycemia After Gastric Bypass
Salehi, M., Gastaldelli, A., & D'Alessio, D. A. (2014) · Gastroenterology · doi:10.1053/j.gastro.2013.11.044 · Cited by 289
Isbell, J. M., Tamboli, R. A., Hansen, E. N., Saliba, J., Dunn, J. P., Phillips, S. E., Marks–Shulman, P. A., & Abumrad, N. N. (2010) · Diabetes Care · doi:10.2337/dc09-2107 · Cited by 248
“Fasting levels of GLP-1 have been reported to remain stable 2–10 weeks after RYGB (1,11,18,19), consistent with our current observations within the 1st postoperative week.”
BackgroundResultInfluentialMechanisms of improved glycaemic control after Roux-en-Y gastric bypass
Dirksen, C., Jørgensen, N. B., Bojsen-Møller, K. N., Jacobsen, S. H., Hansen, D. L., Worm, D., Holst, J. J., & Madsbad, S. (2012) · Diabetologia · doi:10.1007/s00125-012-2556-7 · Cited by 247
“In another study by the same authors, similar changes in incretin effect were found in a group of patients with type 2 diabetes undergoing RYGB, but not in a matched group of patients with type 2 diabetes who achieved a comparable diet-induced weight loss [33].”
BackgroundResultInfluentialThe Role of GLP-1 in the Metabolic Success of Bariatric Surgery
Hutch, C. R., & Sandoval, D. A. (2017) · Endocrinology · doi:10.1210/en.2017-00564 · Cited by 245
“Postprandial levels of GIP have been reported to be similar 2 weeks after (22) or higher 1 month (25) after RYGB compared to preoperative levels.”
BackgroundMethodInfluentialRemission of Type 2 Diabetes After Gastric Bypass and Banding
Pournaras, D. J., Osborne, A., Hawkins, S. C., Vincent, R. P., Mahon, D., Ewings, P., Ghatei, M. A., Bloom, S. R., Welbourn, R., & le Roux, C. W. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181efc49a · Cited by 226
Treatment of obesity and diabetes using oxytocin or analogs in patients and mouse models
Zhang, H., Wu, C., Chen, Q., Chen, X., Xu, Z., Wu, J., & Cai, D. (2013) · PLoS ONE · doi:10.1371/journal.pone.0061477 · Cited by 224
“In addition, bariatric procedures can have immediate effects in lowering blood sugar levels in diabetes prior to evident changes of body weight [4,5], and this obesity-independent hypoglycemic effect has been related to the action of GLP-1 in promoting insulin section [3,6].”
Hypoglycemia After Gastric Bypass Surgery: Current Concepts and Controversies
Salehi, M., Vella, A., McLaughlin, T., & Patti, M.-E. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-00528 · Cited by 239
“surgical controls via unknown mechanisms (20, 22, 23, 39).”
BackgroundManagement of the Metabolic Syndrome and Type 2 Diabetes Through Lifestyle Modification
Magkos, F., Yannakoulia, M., Chan, J. L., & Mantzoros, C. S. (2009) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-080508-141200 · Cited by 217
“This and several other recent studies on surgically induced weight loss and its metabolic benefits (122, 203) have fuelled interest in the putative clinical utility of bariatric surgery in diabetes treatment (108, 221).”
BackgroundEndocrine mechanisms mediating remission of diabetes after gastric bypass surgery
Cummings, D. E. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.15 · Cited by 199
Changes in Gastrointestinal Hormones and Leptin after Roux-en-Y Gastric Bypass Procedure: A Review
Beckman, L. M., Beckman, T. R., & Earthman, C. P. (2010) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2009.12.023 · Cited by 197
Ferrannini, E., & Mingrone, G. (2009) · Diabetes Care · doi:10.2337/dc08-1762 · Cited by 194
“For example, in a nonrandomized study comparing LAGB and RYGB in a large number of nondiabetic patients (66), HOMA at 30 months postsurgery was similar but RYGB induced a significantly larger weight loss than LAGB ( 33 vs. 22%).”
BackgroundInfluentialNarrative Review: Effect of Bariatric Surgery on Type 2 Diabetes Mellitus
Vetter, M. L., Cardillo, S., Rickels, M. R., & Iqbal, N. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-2-200901200-00007 · Cited by 193
“BPD biliopancreatic diversion; LAGB laparoscopic adjustable gastric banding; RYGB Roux-en-Y gastric bypass; VBG vertical banded gastroplasty.”
BackgroundInfluentialNakatani, H., Kasama, K., Oshiro, T., Watanabe, M., Hirose, H., & Itoh, H. (2009) · Metabolism · doi:10.1016/j.metabol.2009.05.006 · Cited by 192
“On the other hand, the study subjects of Laferrere et al included only T2DM patients.”
BackgroundBiological mechanisms that promote weight regain following weight loss in obese humans
Ochner, C. N., M.S, D. M. B., Lee, C. D., & Pi-Sunyer, X. (2013) · Physiology & Behavior · doi:10.1016/j.physbeh.2013.07.009 · Cited by 196
The Gut-Brain Axis, the Human Gut Microbiota and Their Integration in the Development of Obesity
Bliss, E., & Whiteside, E. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00900 · Cited by 196
Mineral Malnutrition Following Bariatric Surgery
Gletsu-Miller, N. A., & Wright, B. N. (2013) · Advances in Nutrition · doi:10.3945/an.113.004341 · Cited by 190
“The physiological mechanisms of RYGB for promoting weight loss are under intense investigation given the acute resolution of T2DM following surgery (42,43), and potential mechanisms include caloric restriction and alterations in secretion of incretins, satiety gastrointestinal hormones, and bile acids and in the micro…”
BackgroundMokadem, M., Zechner, J. F., Margolskee, R. F., Drucker, D. J., & Aguirre, V. (2013) · Molecular Metabolism · doi:10.1016/j.molmet.2013.11.010 · Cited by 181
“, calorie restriction and restrictive bariatric procedures) exhibit comparable improved glucose homeostasis to RYGB [6, 4851].”
BackgroundMetabolic surgery: the role of the gastrointestinal tract in diabetes mellitus
Rubino, F., R'bibo, S. L., del Genio, F., Mazumdar, M., & McGraw, T. E. (2010) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.268 · Cited by 173
“A study where oral glucose tolerance tests were performed in nine obese women with T2DM before and 1 month after RYGB and in 10 matched women after a diet-induced, equivalent weight loss (10 kg) showed a dramatic improvement of oral glucose tolerance and an increase in the levels of glucagon-like peptide-1 (GLP-1) and…”
MethodMechanisms of early improvement / resolution of type 2 diabetes after bariatric surgery
Mingrone, G., & Castagneto‐Gissey, L. (2009) · Diabetes & Metabolism · doi:10.1016/s1262-3636(09)73459-7 · Cited by 171
Fried, M., Ribaric, G., Buchwald, J. N., Svacina, S., Dolezalova, K., & Scopinaro, N. (2010) · Obesity Surgery · doi:10.1007/s11695-010-0113-3 · Cited by 170
“led to elucidation of neurogenic and hormonal mechanisms that are sharpening our understanding of surgery’s effect on diabetes [48–53].”
BackgroundRomero, F., Nicolau, J., Flores, L., Casamitjana, R., Ibarzábal, A., Lacy, A. M., & Vidal, J. (2012) · Surgical Endoscopy · doi:10.1007/s00464-012-2166-y · Cited by 165
“An improvement in the incretinic effect occurring early after surgery has been implicated in the prompt resolution of T2DM after RYGBP [12–14].”
BackgroundResultInfluentialMeal patterns, satiety, and food choice in a rat model of Roux-en-Y gastric bypass surgery
Zheng, H., Shin, A. C., Lenard, N. R., Townsend, R. L., Patterson, L. M., Sigalet, D. L., & Berthoud, H. (2009) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00343.2009 · Cited by 165
Mechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review
Abdeen, G., & le Roux, C. (2016) · Obesity Surgery · doi:10.1007/s11695-015-1945-7 · Cited by 162
“GLP-1 and PYY responses to mixed meals or oral glucose have been at the centre of interest of several studies investigating patients 6 weeks to 10 years after RYGB [46–51].”
BackgroundCampos, G. M., Rabl, C., Peeva, S., Ciovica, R., Rao, M. N., Schwarz, J., Havel, P. J., Schambelan, M., & Mulligan, K. M. (2009) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-009-1060-y · Cited by 160
“At the center of the debate is the relative contribution of greater and sustained weight loss, or to an altered pattern of gut and pancreatic hormone secretion, frequently called the “incretin effect”, or other factors.(13,14) RYGB creates an anatomical rearrangement that delivers a partially digested food bolus direc…”
BackgroundLee, C. J., Clark, J. M., Schweitzer, M., Magnuson, T., Steele, K., Koerner, O., & Brown, T. T. (2015) · Obesity · doi:10.1002/oby.21042 · Cited by 159
“Both RYGB and VSG were shown to increase glucose-mediated GLP-1 secretion and to expedite gastric emptying time after surgery, which are thought to play key roles in increasing the risk of postbariatric surgery hypoglycemia (24,25).”
BackgroundLate endocrine effects of childhood cancer
Rose, S. R., Horne, V. E., Howell, J. C., Lawson, S. A., Rutter, M. M., Trotman, G. E., & Corathers, S. D. (2016) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2016.45 · Cited by 154
Effects of Bariatric Surgery on Glucose Homeostasis and Type 2 Diabetes
Bradley, D. P., Magkos, F., & Klein, S. (2012) · Gastroenterology · doi:10.1053/j.gastro.2012.07.114 · Cited by 154
Meal-Induced Hormone Responses in a Rat Model of Roux-en-Y Gastric Bypass Surgery
Shin, A. C., Zheng, H., Townsend, R. L., Sigalet, D. L., & Berthoud, H. (2010) · Endocrinology · doi:10.1210/en.2009-1332 · Cited by 150
“Similarly exaggerated GLP-1 (7, 9, 27–29) and PYY (5, 7, 9, 28, 29) responses to a mixed meal or oral glucose (10) ingestion have been reported in RYGB patients 6 wk to 48 months after surgery.”
BackgroundWeight Regain After Gastric Bypass: Influence of Gut Hormones
Santo, M. A., Riccioppo, D., Pajecki, D., Kawamoto, F., de Cleva, R., Antonangelo, L., Marçal, L., & Cecconello, I. (2016) · Obesity Surgery · doi:10.1007/s11695-015-1908-z · Cited by 145
“Conclusions The secretion of gut hormones in patients with weight regain after RYGB is different from that in patients with satisfactory weight outcome.”
BackgroundResultInfluentialBariatric surgery: an IDF statement for obese Type 2 diabetes
Dixon, J. B., Zimmet, P., Alberti, K. G. M. M., & Rubino, F. (2011) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302011000600003 · Cited by 148
Olbers, T., Gronowitz, E., Werling, M., Marlid, S., Flodmark, C., Peltonen, M., Gothberg, G., Karlsson, J., Ekbom, K., Sjöström, L., et al. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.160 · Cited by 149
Shah, M., Law, J. H., Micheletto, F., Sathananthan, M., Man, C. D., Cobelli, C., Rizza, R. A., Camilleri, M., Zinsmeister, A. R., & Vella, A. V. (2013) · Diabetes · doi:10.2337/db13-0954 · Cited by 134
“It has been presumed that the increase in GLP-1 after meal ingestion post-RYGB is related to rapid delivery of food to the incretin-secreting portions of the intestine (9,40,41).”
BackgroundPurnell, J. Q., Selzer, F., Wahed, A. S., Pender, J. R., Pories, W. J., Pomp, A., Dakin, G. F., Mitchell, J. E., Garcia, L., Staten, M. A., et al. (2016) · Diabetes Care · doi:10.2337/dc15-2138 · Cited by 136
“Immediately after Roux-en-Y gastric bypass (RYGBP), improvement in hyperglycemia typically occurs rapidly and is thought to be due, in part, to an acute reduction in calorie intake (7) as well as independent gastrointestinal hormonal effects unique to this operation as compared with laparoscopic gastric banding (LAGB)…”
BackgroundBariatric surgery: an IDF statement for obese Type 2 diabetes
Dixon, J. B., Zimmet, P., Alberti, K. G. M. M., & Rubino, F. (2011) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2011.05.013 · Cited by 134
Changes in neurohormonal gut peptides following bariatric surgery
Ochner, C. N., Gibson, C. D., Shanik, M. H., Goel, V., & Geliebter, A. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.132 · Cited by 137
Laferrère, B., Swerdlow, N. J., Bawa, B., Arias, S., Bose, M., Oliván, B., Teixeira, J. A., McGinty, J., & Rother, K. I. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2767 · Cited by 132
“The surgical group was studied before and 1 month after GBP, whereas the control group was studied before and after a 10-kg diet-induced weight loss (5, 6).”
MethodJohnson, B. L., Blackhurst, D. W., Latham, B. B., Cull, D. L., Bour, E. S., Oliver, T. L., Williams, B. R., Taylor, S. M., & Scott, J. D. (2013) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2012.12.019 · Cited by 131
Salehi, M., Gastaldelli, A., & D'Alessio, D. A. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2686 · Cited by 130
Early Postoperative Insulin-Resistance Changes After Sleeve Gastrectomy
Rizzello, M., Abbatini, F., Casella, G., Alessandri, G., Fantini, A., Leonetti, F., & Basso, N. (2009) · Obesity Surgery · doi:10.1007/s11695-009-0017-2 · Cited by 133
“Few studies reported the effect of bariatric surgery on GIP levels: in several studies reduction or no change in fasting GIP levels after GBP or BPD was observed [28, 29].”
BackgroundMechanisms of Weight Regain following Weight Loss
Blomain, E. S., Dirhan, D., Valentino, M. A., Kim, G. W., & Waldman, S. A. (2013) · ISRN Obesity · doi:10.1155/2013/210524 · Cited by 143
Umeda, L. M., Silva, E. A., Carneiro, G., Arasaki, C. H., Geloneze, B., & Zanella, M. T. (2011) · Obesity Surgery · doi:10.1007/s11695-011-0412-3 · Cited by 128
Bose, M., Oliván, B., Teixeira, J., Pi-Sunyer, X., & Laferrère, B. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9696-3 · Cited by 132
“Many studies have observed a reduction [66, 76] or no change [62, 64] in fasting GIP levels after BPD or GBP.”
BackgroundResultInfluentialASMBS Position Statement on Postprandial Hyperinsulinemic Hypoglycemia after Bariatric Surgery
Eisenberg, D., Azagury, D. E., Ghiassi, S., Grover, B. T., & Kim, J. J. (2016) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2016.12.005 · Cited by 130
Osto, E., Doytcheva, P., Corteville, C., Bueter, M., Dörig, C., Stivala, S., Buhmann, H., Colin, S., Rohrer, L., Hasballa, R., et al. (2015) · Circulation · doi:10.1161/circulationaha.114.011791 · Cited by 128
“In particular, plasma levels of the gut hormone glucagon-like peptide-1 (GLP-1) increase rapidly after RYGB but not after dietary restriction despite a similar weight loss.(15,16,18) These observations raised the hypothesis that changes in GLP-1 levels mediate the rapid and surgery-specific metabolic improvement achie…”
BackgroundJiménez, A., Casamitjana, R., Viaplana-Masclans, J., Lacy, A. M., & Vidal, J. (2013) · Diabetes Care · doi:10.2337/dc12-1535 · Cited by 119
“A paradoxical glucagon response after meal intake in RYGBP patients previously has been reported both during the shortterm and the long-term after surgery after nutrient challenge with different composition, and in subjects with or without a history of T2DM preceding the surgical procedure (8,18,23,33,34).”
BackgroundGrams, J. M., & Garvey, W. T. (2015) · Current Obesity Reports · doi:10.1007/s13679-015-0155-x · Cited by 127
Evaluation of the incretin effect in humans using GIP and GLP-1 receptor antagonists
Gasbjerg, L. S., Bergmann, N. C., Stensen, S., Christensen, M. B., Rosenkilde, M. M., Holst, J. J., Nauck, M., & Knop, F. K. (2020) · Peptides · doi:10.1016/j.peptides.2019.170183 · Cited by 121
Sweeney, T. E., & Morton, J. M. (2014) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2014.07.016 · Cited by 126
Bose, M., Teixeira, J. A., Oliván, B., Bawa, B., Arias, S., Machineni, S., Pi‐Sunyer, F. X., Scherer, P. E., & Laferrère, B. (2009) · Journal of Diabetes · doi:10.1111/j.1753-0407.2009.00064.x · Cited by 118
“Some of the effects of GBP on diabetes control may be secondary to caloric restriction and weight loss because they improve similarly after GBP or an equivalent diet-induced weight loss.(3) In contrast, the early change in incretins occurs independently of weight loss and may be related to the nature of the surgery.”
BackgroundResultInfluentialBile Diversion in Roux-en-Y Gastric Bypass Modulates Sodium-Dependent Glucose Intestinal Uptake
Baud, G., Daoudi, M., Hübert, T., Raverdy, V., Pigeyre, M., Hervieux, E., Devienne, M., Ghunaim, M., Bonner, C., Quenon, A., et al. (2016) · Cell Metabolism · doi:10.1016/j.cmet.2016.01.018 · Cited by 129
“, 1998) and to a greater extent than expected from weight loss alone (Laferrère et al., 2008).”
BackgroundEvers, S. S., Sandoval, D. A., & Seeley, R. J. (2016) · Annual Review of Physiology · doi:10.1146/annurev-physiol-022516-034423 · Cited by 120
Hypertrophy Dependent Doubling of L-Cells in Roux-en-Y Gastric Bypass Operated Rats
Hansen, C. F., Bueter, M., Theis, N., Lutz, T. A., Paulsen, S. J., Dalbøge, L. S., Vrang, N., & Jelsing, J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0065696 · Cited by 115
“loss [14].”
Kindel, T. L., Yoder, S. M., Seeley, R. J., D’Alessio, D. A., & Tso, P. (2009) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-009-0912-9 · Cited by 114
Rapid improvement in diabetes after gastric bypass surgery
Lingvay, I., Guth, E., Islam, A., & Livingston, E. (2013) · Diabetes Care · doi:10.2337/dc12-2316 · Cited by 116
“(13) studied the effect of RYGB on diabetes but matched for weight loss rather than caloric intake.”
BackgroundRoux-en-Y Gastric Bypass Corrects Hyperinsulinemia Implications for the Remission of Type 2 Diabetes
Reed, M. A., Pories, W. J., Chapman, W. H. H., Pender, J. R., Bowden, R., Barakat, H. A., Gavin, T. P., Green, T., Tapscott, E., Zheng, D., et al. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-0165 · Cited by 114
Treatment of overweight and obesity: Lifestyle, pharmacologic, and surgical options
Cannon, C. P., & Kumar, A. (2009) · Clinical cornerstone · doi:10.1016/s1098-3597(09)80005-7 · Cited by 116
Mechanisms facilitating weight loss and resolution of type 2 diabetes following bariatric surgery
Karra, E., Yousseif, A., & Batterham, R. L. (2010) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2010.01.006 · Cited by 114
Dirksen, C., Hansen, D. L., Madsbad, S., Hvolris, L., Naver, L., Holst, J. J., & Worm, D. (2009) · Diabetes Care · doi:10.2337/dc09-1374 · Cited by 107
“Regarding GIP, some studies have demonstrated increased (7,10) and others decreased (9,13) responses after RYGB.”
Mechanisms responsible for excess weight loss after bariatric surgery
Ionut, V., & Bergman, R. N. (2011) · Journal of Diabetes Science and Technology · doi:10.1177/193229681100500536 · Cited by 105
Camastra, S., Muscelli, E., Gastaldelli, A., Holst, J. J., Astiarraga, B., Baldi, S., Nannipieri, M., Ciociaro, D., Anselmino, M., Mari, A., et al. (2013) · Diabetes · doi:10.2337/db13-0321 · Cited by 106
“A number of previous studies have documented the effects of the most popular bariatric operation, RYGB, on glycemic control and incretin hormones (10-24), and mechanistic studies have explored the ability of RYGB to enhance insulin action and ß-cell function.”
BackgroundTherapeutic potential for GIP receptor agonists and antagonists
Irwin, N., & Flatt, P. R. (2009) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2009.03.001 · Cited by 105
Mechanism for Improved Insulin Sensitivity after Gastric Bypass Surgery
Bikman, B. T., Zheng, D., Pories, W. J., Chapman, W. H. H., Pender, J. R., Bowden, R., Reed, M. A., Cortright, R. N., Tapscott, E. B., Houmard, J. A., et al. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1030 · Cited by 106
“(41) compared subjects who experienced comparable levels of weight loss due to hypocaloric diet and surgery.”
Background
Metadata
- Authors
- Laferrère, B., Teixeira, J., McGinty, J., Tran, H., Egger, J. R., Colarusso, A., Kovack, B., Bawa, B., Koshy, N., Lee, H., Yapp, K., & Olivan, B.
- Affiliations
- Obesity Research Center (B.L., H.T., J.R.E., A.C., B.K., B.B., K.Y., B.O.), St. Luke’s/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025
- Bariatric Division (J.T., J.M., N.K., H.L.), St. Luke’s/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025
- St. Luke's-Roosevelt Hospital Center (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2008-07-01
- Volume
- 93
- Issue
- 7
- Pages
- 2479-2485
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2453054
- OpenAlex
- W2146737709
- Cited by
- 682
- References
- 57
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 11 · 2023: 18 · 2022: 17 · 2021: 25 · 2020: 25 · 2019: 39 · 2018: 21 · 2017: 45 · 2016: 48 · 2015: 44 · 2014: 57 · 2013: 72 · 2012: 59
- FWCI
- 63.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK 67561, DK63068-05, DK 26687, R01DK067561, P30DK026687)
- National Center for Research Resources (UL1RR024156)
- 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
- gastric bypass, type 2 diabetes, weight loss, incretin effect, glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide, proinsulin, glucagon, insulin, postprandial blood glucose, hypocaloric diet, obesity, women
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 2, Diet, Reducing, Female, Gastric Inhibitory Polypeptide, Glucagon, Humans, Male, Middle Aged, Obesity, Gastric Bypass, Weight Loss, Glucagon-Like Peptide 1, Incretins
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