Cited by 682Bariatric Surgery and OutcomesDiabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

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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

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Laferrère, Blandine, Teixeira, Julio, McGinty, James, Tran, Hao, Egger, Joseph R., Colarusso, Antonia, Kovack, Betty, Bawa, Baani, Koshy, Ninan, Lee, Hongchan, Yapp, Kimberly, Olivan, Blanca·2008·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2007-2851PMC PMC2453054

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Abstract

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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Laferrère, 2007, The increase in GLP-1 levels and incretin effect after Roux-en-Y gastric bypass surgery (RYGBP) persists up to 1 year in patients with type 2 diabetes mellitus (T2DM), Obesity, 15, 7

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Result
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BackgroundMethodResultInfluential
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“This appears to be an incretin effect, but other mechanisms may also be involved.(17,18) A central part of the process for selecting the appropriate surgical treatment options is an assessment of the risk versus benefit of each operation for each individual patient.”
Background
Altered glucose metabolism after bariatric surgery: What's GLP-1 got to do with it?
Smith, E. P., Polanco, G., Yaqub, A., & Salehi, M. (2017) · Metabolism · doi:10.1016/j.metabol.2017.10.014 · Cited by 52
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“In addition, the restoration of insulin secretion in response to oral glucose following gastric bypass is not observed in patients after equivalent diet-induced weight loss[7].”
Background
Effect of meal size and texture on gastric pouch emptying and glucagon-like peptide 1 after gastric bypass surgery
Stano, S., Alam, F., Wu, L., Dutia, R., Ng, S.-N., Sala, M., McGinty, J., & Laferrère, B. (2017) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2017.09.004 · Cited by 46
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Influential
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Li, M., Liu, Z., Qian, B., Liu, W., Horimoto, K., Xia, J. L., Shi, M., Wang, B., Zhou, H., & Chen, L. (2020) · Cell Discovery · doi:10.1038/s41421-019-0138-2 · Cited by 45
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Cohen, R., Caravatto, P., Correa, J. L., Noujaim, P., Petry, T., Salles, J., & Schiavon, C. (2012) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2012.01.017 · Cited by 42
“However, when patients lose a lower amount of eight, such as in the present study, several other studies ave shown a minimal decrease in HbA1c levels [17], no mprovement in skeletal muscle insulin sensitivity [15], and o increase in insulin responses to glucose loads [18].”
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Laparoscopic Greater Curvature Plication in Morbidly Obese Women with Type 2 Diabetes: Effects on Glucose Homeostasis, Postprandial Triglyceridemia and Selected Gut Hormones
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“Findings regarding changes in fasting GLP-1 levels after RYGB surgery are also mixed [121,127], but most report higher postprandial levels post-surgery in RYGB [97,105,131,133].”
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“The GLP-1 component delivers a rapid incretin response and fullness after small meals, actions thought by some investigators to be crucial in the early improvement in type-2 diabetes and the weight loss efficacy of this procedure (Laferrere et al., 2008) (le Roux et al.”
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Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect
Holter, M. M., Dutia, R., Stano, S., Prigeon, R. L., Homel, P., McGinty, J. J., Belsley, S., Ren, C. J., Rosen, D., & Laferrère, B. (2016) · Diabetes Care · doi:10.2337/dc16-1376 · Cited by 45
“Gastric inhibitory polypeptide (GIP) was determined by ELISA, which reacts 100% with GIP(1-42) and GIP(3-42), but not with GLP-1, GLP-2, oxyntomodulin, or glucagon.”
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Takeda G Protein-Coupled Receptor 5-Mechanistic Target of Rapamycin Complex 1 Signaling Contributes to the Increment of Glucagon-Like Peptide-1 Production after Roux-en-Y Gastric Bypass
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IGFBP-2 partly mediates the early metabolic improvements caused by bariatric surgery
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“RYGB and SG are the most commonly performed bariatric surgical procedures [100–102] and result in significant and sustained weight loss accompanied by dramatic glucose metabolism changes [103, 104].”
Background
Early Improvement of Postprandial Lipemia After Bariatric Surgery in Obese Type 2 Diabetic Patients
Griffo, E., Nosso, G., Lupoli, R., Cotugno, M., Saldalamacchia, G., Vitolo, G., Angrisani, L., Cutolo, P. P., Rivellese, A. A., & Capaldo, B. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1148-z · Cited by 41
“However, animal as well as human studies have shown that, at comparable weight loss, bariatric surgery induces a much greater incretin response and more profound metabolic changes than calorie restriction, indicating that, beyond fasting, factors specifically related to surgery may play beneficial effects [11, 28, 29].”
Background
Effects of glucagon like peptide-1 to mediate glycemic effects of weight loss surgery
Salehi, M., & D’Alessio, D. A. (2014) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-014-9291-y · Cited by 41
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Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?
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“The improved incretin effect among subjects with RYGB, who have rapid, supranormal glucose excursions after eating (25), is best explained by the rapid flux of glucose from the gut and the enormous postprandial GLP-1 secretion and action characteristic of these individuals (10).”
Background
Changes in insulin sensitivity and secretion after sleeve gastrectomy
Casella, G., Soricelli, E., Castagneto‐Gissey, L., Redler, A., Basso, N., & Mingrone, G. (2015) · British journal of surgery · doi:10.1002/bjs.10039 · Cited by 38
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“The secretion of GIP and GLP-1 increases after RYGB and the result of their effect on insulin may be the main reason for the decrease in glucose level [25,26].”
Background
The Surgical Treatment of Type II Diabetes Mellitus: Changes in HOMA Insulin Resistance in the First Year Following Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) and Laparoscopic Adjustable Gastric Banding (LAGB)
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“compared the impact of a hypocaloric diet and LRYGB on glucose and incretin levels [30].”
Background
The foregut theory as a possible mechanism of action for the remission of type 2 diabetes in low body mass index patients undergoing subtotal gastrectomy for gastric cancer
Kwon, Y., Abdemur, A., Menzo, E. L., Park, S. S., Szomstein, S., & Rosenthal, R. J. (2013) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2013.09.013 · Cited by 37
“Experimental studies in humans [10–12] suggest that certain bariatric procedures may improve diabetes control through mechanisms other than weight loss [13].”
Background
Hypothalamic Obesity: 4 Years of the International Registry of Hypothalamic Obesity Disorders
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Fructose Consumption Contributes to Hyperinsulinemia in Adolescents With Obesity Through a GLP-1–Mediated Mechanism
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Long-term results of a randomized trial comparing banded versus standard laparoscopic Roux-en–Y gastric bypass
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“Linner, Fobi, and Capella, among others, have suggested reinforcement of either the pouch or the anastomosis with a prosthetic material to avoid the risk of dilation and to maintain the weight loss [2–4].”
Background
Metabolic surgery—principles and current concepts
Gass, M., Beglinger, C., & Peterli, R. (2011) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-011-0834-3 · Cited by 34
Predicting Remission of Diabetes After RYGB Surgery Following Intensive Management to Optimize Preoperative Glucose Control
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Gastric bypass surgery, but not caloric restriction, decreases dipeptidyl peptidase‐4 activity in obese patients with type 2 diabetes
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“A similar rise in incretin levels was not observed after matched weight loss by diet [4] or after GB surgery [5].”
BackgroundMethodResultInfluential
Mechanisms of bariatric surgery for weight loss and diabetes remission
Yin, M., Wang, Y., Han, M., Liang, R., Li, S., Wang, G., & Gang, X. (2023) · Journal of Diabetes · doi:10.1111/1753-0407.13443 · Cited by 36
“For example, with the same weight loss, postprandial glucose levels decreased more and the GLP-1 levels increased more at 1 month after gastric bypass surgery (GBP) compared with a low-caloric diet, 14 indicating that mechanisms may be partially independent of weight loss.”
Adipose Tissue in Cardiovascular Disease: From Basic Science to Clinical Translation
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Magnitude and Variability of the Glucagon-Like Peptide-1 Response in Patients With Type 2 Diabetes up to 2 Years Following Gastric Bypass Surgery
der Schueren, B. V., Homel, P., Alam, M., Agenor, K., Wang, G., Reilly, D., & Laferrère, B. (2011) · Diabetes Care · doi:10.2337/dc11-1472 · Cited by 34
“Plasma samples were collected and analyzed as described previously (1,2).”
Method
Mechanisms behind the immediate effects of Roux-en-Y gastric bypass surgery on type 2 diabetes
Allen, R. E., Hughes, T. D., Ng, J. L., Ortiz, R. D., Ghantous, M. A., Bouhali, O., Froguel, P., & Arredouani, A. (2013) · Theoretical Biology and Medical Modelling · doi:10.1186/1742-4682-10-45 · Cited by 34
“Consistent with elevated postprandial GLP-1 secretion, post-RYGB patients display an increased incretin effect [35].”
Metabolic Effects of Gastric Bypass Surgery: Is It All About Calories?
Herzog, K., Berggren, J., Majdoub, M. A., Balderas, C., Lindqvist, A., Hedenbro, J., Groop, L., Wierup, N., & Spégel, P. (2020) · Diabetes · doi:10.2337/db20-0131 · Cited by 35
“Despite these similarities, RYGB causes a more rapid T2D remission when compared with VLCD (26), as well as having different effects on the plasma metabolome (27).”
Background
Short-Term Changes of the Urine Metabolome After Bariatric Surgery
Friedrich, N., Budde, K., Wolf, T., Jungnickel, A., Grotevendt, A., Dreßler, M., Völzke, H., Blüher, M., Nauck, M. A., Lohmann, T., et al. (2012) · OMICS A Journal of Integrative Biology · doi:10.1089/omi.2012.0066 · Cited by 34
“For instance, an increase in post-prandial glucagon-like peptide-1 levels and an improved effect of incretin on insulin secretion were observed (Bose et al., 2009; Laferrere et al., 2008).”
Small intestinal metabolism is central to whole-body insulin resistance
Angelini, G., Salinari, S., Castagneto‐Gissey, L., BERTUZZI, A., Casella-Mariolo, J. R., Ahlin, S., Boškoski, I., Gaggini, M., Raffaelli, M., Costamagna, G., et al. (2020) · Gut · doi:10.1136/gutjnl-2020-322073 · Cited by 33
Role of Gut-Related Peptides and Other Hormones in the Amelioration of Type 2 Diabetes after Roux-en-Y Gastric Bypass Surgery
Hage, M. P., Safadi, B. Y., Salti, I., & Nasrallah, M. (2012) · ISRN Endocrinology · doi:10.5402/2012/504756 · Cited by 35
“2008 [49] Prospective controlled 9 F T2D RYGB 10 F T2D diet induced weight loss 43.”
Result
Glucose‐dependent insulinotropic polypeptide: from pathophysiology to therapeutic opportunities in obesity‐associated disorders
Paschetta, E., Hvalryg, M., & Musso, G. (2011) · Obesity Reviews · doi:10.1111/j.1467-789x.2011.00897.x · Cited by 34
Metabolic comparison of one-anastomosis gastric bypass, single-anastomosis duodenal-switch, Roux-en-Y gastric bypass, and vertical sleeve gastrectomy in rat
Arble, D. M., Evers, S. S., Bozadjieva-Kramer, N., Frikke‐Schmidt, H., Myronovych, A., Lewis, A. G., Toure, M. H., & Seeley, R. J. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.08.019 · Cited by 32
Rapid changes in neuroendocrine regulation may contribute to reversal of type 2 diabetes after gastric bypass surgery
Katsogiannos, P., Kamble, P. G., Wiklund, U., Sundbom, M., Espes, D., Hammar, U., Karlsson, F. A., Pereira, M. J., & Eriksson, J. W. (2020) · Endocrine · doi:10.1007/s12020-020-02203-w · Cited by 38
Obesity-related cardiorenal disease: the benefits of bariatric surgery
Fenske, W., Athanasiou, T., Harling, L., Drechsler, C., Darzi, A. W., & Ashrafian, H. (2013) · Nature Reviews Nephrology · doi:10.1038/nrneph.2013.145 · Cited by 32
Relevance of beta-cell function for improved glycemic control after gastric bypass surgery
Blanco, J., Jiménez, A., Casamitjana, R., Flores, L., Lacy, A. M., Conget, I., & Vidal, J. (2013) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2013.07.020 · Cited by 32
Preoperative β‐cell function in patients with type 2 diabetes is important for the outcome of Roux‐en‐Y gastric bypass surgery
Lund, M. T., Hansen, M., Skaaby, S., Dalby, S., Støckel, M., Floyd, A. K., Bech, K., Helge, J. W., Holst, J. J., & Dela, F. (2015) · The Journal of Physiology · doi:10.1113/jp270264 · Cited by 31
“…but in addition a major increase in postprandial glucagon-like peptide-1 (GLP-1) plasma concentration is a constant finding after RYGB (le Roux et al. 2007; Laferrere et al. 2007, 2008; Morinigo et al. 2006; Bose et al. 2010; Jorgensen et al. 2012; Salinari et al. 2013; Bojsen-Moller et al. 2014).”
Background
Remission of type 2 diabetes mellitus following bariatric surgery: review of mechanisms and presentation of the concept of ‘reversibility’
Perugini, R. A., & Malkani, S. (2011) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e3283446c1f · Cited by 31
Bariatric Surgery in Hypothalamic Obesity
Bingham, N. C., Rose, S. R., & Inge, T. H. (2012) · Frontiers in Endocrinology · doi:10.3389/fendo.2012.00023 · Cited by 32
Intestinal peptide changes after bariatric and minimally invasive surgery: Relation to diabetes remission
Castagneto‐Gissey, L., Mariolo, J. R. C., & Mingrone, G. (2018) · Peptides · doi:10.1016/j.peptides.2017.12.010 · Cited by 32
“During portal infusion of GLP1 in dogs, active GLP1 concentrations reached 200 pmol/l in the arterial plasma and 500 pmol/l in the portal vein, values that are 8–20 times the post-prandial concentration reached after RYGB [71].”
Vascular Risk Reduction in Obesity through Reduced Granulocyte Burden and Improved Angiogenic Monocyte Content following Bariatric Surgery
Hess, D. A., Trac, J. Z., Glazer, S. A., Terenzi, D. C., Quan, A., Teoh, H., Al-Omran, M. A., Bhatt, D. L., Mazer, C. D., Rotstein, O. D., et al. (2020) · Cell Reports Medicine · doi:10.1016/j.xcrm.2020.100018 · Cited by 33
“Laferrère et al.16 have shown that bariatric surgery resulted in a 5- to 6- fold increase in GLP-1 levels and insulin secretion after glucose load, when compared with equal weight loss through low caloric intake.”
Background
Controversies in bariatric surgery
O’Brien, P. E. (2015) · British journal of surgery · doi:10.1002/bjs.9760 · Cited by 31
Common and Rare Complications of Bariatric Surgery
Collazo–Clavell, M. L., & Shah, M. (2020) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2020.02.003 · Cited by 31
Lessons from bariatric surgery: Can increased GLP-1 enhance vascular repair during cardiometabolic-based chronic disease?
Bakbak, E., Terenzi, D. C., Trac, J. Z., Teoh, H., Quan, A., Glazer, S. A., Rotstein, O. D., Al-Omran, M. A., Verma, S., & Hess, D. A. (2021) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-021-09669-7 · Cited by 32
“reported that GLP-1 levels were significantly increased following gastric bypass compared to age-, body weight-, duration of diabetes-, and weight loss-matched controls on a low-calorie diet [69].”
Background
Roux‐en‐Y versus one‐anastomosis gastric bypass (RYSA study): weight loss, metabolic improvements, and nutrition at 1 year after surgery, a multicenter randomized controlled trial
Heinonen, S., Saarinen, T., Meriläinen, S. A., Sammalkorpi, H. E., Penttilä, A. K., Koivikko, M. L., Siira, P. T., Karppinen, J. I., Säiläkivi, U., Rosengård‐Bärlund, M., et al. (2023) · Obesity · doi:10.1002/oby.23852 · Cited by 31
Fasting plasma triglycerides predict the glycaemic response to treatment of Type 2 diabetes by gastric electrical stimulation. A novel lipotoxicity paradigm
Lebovitz, H. E., Ludvik, B. H., Yaniv, I., Haddad, W., Schwartz, T. P., & Aviv, R. (2013) · Diabetic Medicine · doi:10.1111/dme.12132 · Cited by 31
Liver Transplantation and Bariatric Surgery
Suraweera, D., Dutson, E., & Saab, S. (2017) · Clinics in Liver Disease · doi:10.1016/j.cld.2016.12.001 · Cited by 29
GLP-1 is not the key mediator of the health benefits of metabolic surgery
Vidal, J., de Hollanda, A., & Jiménez, A. (2016) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2016.02.029 · Cited by 29
“A parallel improvement of glucose homeostasis and enlarged GLP-1 response to meal intake has been demonstrated in several studies in subjects with type 2 diabetes (T2D) who underwent RYGB or SG (9-14, 16) .”
BackgroundInfluential
Bariatric Surgery Reduces Oxidative Stress by Blunting 24-h Acute Glucose Fluctuations in Type 2 Diabetic Obese Patients
Marfella, R., Barbieri, M., Ruggiero, R., Rizzo, M. R., Grella, R., Mozzillo, A. L., Docimo, L., & Paolisso, G. (2009) · Diabetes Care · doi:10.2337/dc09-1343 · Cited by 29
“According to the previous data (9,10), both GLP-1 and glucagon responses to standardized meals markedly increased 1 month after BPD and 10-kg diet-induced weight loss, without significant differences among the groups.”
Proglucagon peptide secretion profiles in type 2 diabetes before and after bariatric surgery: 1-year prospective study
Αλεξιάδου, Κ., Cuenco, J., Howard, J., Albrechtsen, N. J. W., Ilesanmi, I., Kamocka, A., Tharakan, G., Behary, P., Bech, P., Ahmed, A. R., et al. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-001076 · Cited by 29
Attenuated secretion of glucose-dependent insulinotropic polypeptide (GIP) does not alleviate hyperphagic obesity and insulin resistance in ob/ob mice
Shimazu‐Kuwahara, S., Harada, N., Yamane, S., Joo, E., Sankoda, A., Kieffer, T. J., & Inagaki, N. (2017) · Molecular Metabolism · doi:10.1016/j.molmet.2017.01.006 · Cited by 28
“The altered flow of nutrients in the gut following bariatric surgery may be associated with adaptive changes in the enteroendocrine cell populations [29e31] and altered production of gastrointestinal hormones, including increases in plasma GIP and GLP1 levels post surgery [28,32,33].”
Background
GUB06‐046, a novel secretin/glucagon‐like peptide 1 co‐agonist, decreases food intake, improves glycemic control, and preserves beta cell mass in diabetic mice
van Witteloostuijn, S. B., Dalbøge, L. S., Hansen, G., Midtgaard, S. R., Jensen, G. V., Jensen, K. J., Vrang, N., Jelsing, J., & Pedersen, S. L. (2017) · Journal of Peptide Science · doi:10.1002/psc.3048 · Cited by 28
Long-term outcomes of laparoscopic sleeve gastrectomy from the Indian subcontinent
Misra, S., Bhattacharya, S. S., Kumar, S. S., Nandhini, B. D., Saminathan, S. C., & Raj, P. (2019) · Obesity Surgery · doi:10.1007/s11695-019-04103-z · Cited by 28
Differences in Weight Loss and Gut Hormones: Rouen-Y Gastric Bypass and Sleeve Gastrectomy Surgery
Malin, S. K., & Kashyap, S. R. (2015) · Current Obesity Reports · doi:10.1007/s13679-015-0151-1 · Cited by 28
Potential mechanisms by which bariatric surgery improves systemic metabolism
Koshy, A. A., Bobe, A. M., & Brady, M. (2012) · Translational research · doi:10.1016/j.trsl.2012.09.004 · Cited by 26
Gastric Bypass Increases Postprandial Insulin and GLP-1 in Nonobese Minipigs
Verhaeghe, R., Zerrweck, C., Hübert, T., Trechot, B., Gmyr, V., D’Herbomez, M., Pigny, P., Pattou, F. N., & Caiazzo, R. J. (2014) · European Surgical Research · doi:10.1159/000355678 · Cited by 27
Intestinal Glycolysis Visualized by FDG PET/CT Correlates With Glucose Decrement After Gastrectomy
Ku, C. R., Lee, N., Hong, J. W., Kwon, I. G., Hyung, W. J., Noh, S. H., Lee, E. J., Yun, M., & Cho, A. E.-H. (2016) · Diabetes · doi:10.2337/db16-1000 · Cited by 26
“Still others have shown (13) that bariatric surgery improved glucose homeostasis independently from changes in body weight after surgery.”
Background
Preserving Duodenal-Jejunal (Foregut) Transit Does Not Impair Glucose Tolerance and Diabetes Remission Following Gastric Bypass in Type 2 Diabetes Sprague-Dawley Rat Model
Dolo, P. R., Yao, L., Li, C., Zhu, X., Shi, L., & Widjaja, J. (2017) · Obesity Surgery · doi:10.1007/s11695-017-2985-y · Cited by 26
“While some recorded an increase [18], other reported a decrease [6].”
Background
Vertical sleeve gastrectomy triggers fast β-cell recovery upon overt diabetes
Oppenländer, L., Palit, S., Stemmer, K., Greisle, T., Sterr, M., Salinno, C., Bastidas-Ponce, A., Feuchtinger, A., Böttcher, A., Ansarullah, M., et al. (2021) · Molecular Metabolism · doi:10.1016/j.molmet.2021.101330 · Cited by 24
“Strikingly, studies of human and animal models show that glycaemic control is rapidly improved after bariatric surgery and prior to its primary effect on weight loss [20 e 24], suggesting that factors independent of decreased obesity cause changes in glucose regulation and diabetes remission.”
Gastrointestinal Hormones and Weight Loss Maintenance Following Roux-en-Y Gastric Bypass
de Hollanda, A., Casals, G., Delgado, S., Jiménez, A., Viaplana, J., Lacy, A. M., & Vidal, J. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-3065 · Cited by 26
Isolated duodenal exclusion increases energy expenditure and improves glucose homeostasis in diet-induced obese rats
Muñoz, R., Carmody, J. S., Stylopoulos, N., Davis, P. J., & Kaplan, L. M. (2012) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00262.2012 · Cited by 26
Insulin sensitivity and secretion modifications after bariatric surgery.
Castagneto‐Gissey, L., & Mingrone, G. (2012) · PubMed · doi:10.3275/8470 · Cited by 26
Metabolic surgery for type 2 diabetes
Ahn, S. M., Pomp, A., & Rubino, F. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2011.05984.x · Cited by 25
GLP-1 and Glucagon Secretion from a Pancreatic Neuroendocrine Tumor Causing Diabetes and Hyperinsulinemic Hypoglycemia
Roberts, R. E., Zhao, M., Whitelaw, B., Ramage, J. K., Díaz‐Cano, S. J., le Roux, C. W., Quaglia, A., Huang, G. C., & Aylwin, S. J. B. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2005 · Cited by 25
“We contend that the islet cell hyperplasia was a consequence of very high postprandial levels of GLP-1, greater than those we have previously demonstrated in normal individuals (29) or after Roux-en-Y gastric bypass surgery (30).”
Result
Mechanisms for the metabolic success of bariatric surgery
Sandoval, D. A. (2019) · Journal of Neuroendocrinology · doi:10.1111/jne.12708 · Cited by 26
Advances in the surgical treatment of morbid obesity.
Stefater, M., Kohli, R., & Inge, T. (2013) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2012.10.006 · Cited by 27
“Glycemic improvement following RYGB is superior to dieting alone (Laferrere et al., 2008).”
Background
Peripheral, but not central, GLP-1 receptor signaling is required for improvement in glucose tolerance after Roux-en-Y gastric bypass in mice
Carmody, J. S., Muñoz, R., Yin, H., & Kaplan, L. M. (2016) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00412.2015 · Cited by 25
Metabolic and cardiovascular outcomes of bariatric surgery
Iqbal, Z., Adam, S., Ho, J. H., Syed, A. A., Ammori, B. J., Malik, R. A., & Soran, H. (2020) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000696 · Cited by 24
Bariatric Surgery and Diabetes: Who Should Be Offered the Option of Remission?
Purnell, J. Q., & Flum, D. R. (2009) · JAMA · doi:10.1001/jama.2009.541 · Cited by 24
The emerging role of the intestine in metabolic diseases
Bradley, W. D., Zwingelstein, C., & Rondinone, C. M. (2011) · Archives of Physiology and Biochemistry · doi:10.3109/13813455.2011.578651 · Cited by 24
“In fact, head to head studies of bypass versus restrictive procedures, or bypass versus non-surgical caloric restriction show greater improvements in glycaemic control in patients receiving gastric bypass, indicating a weight independent mechanism triggering early disease resolution (Korner et al., 2007; Laferrere et…”
Background
Comparative effect of intraduodenal and intrajejunal glucose infusion on the gut–incretin axis response in healthy males
Wu, T., Thazhath, S. S., Marathe, C. S., Bound, M. J., Jones, K. L., Horowitz, M., & Rayner, C. K. (2015) · Nutrition and Diabetes · doi:10.1038/nutd.2015.6 · Cited by 24
“Metabolic” Surgery For Treatment Of Type 2 Diabetes Mellitus
Schulman, A., del Genio, F., Sinha, N., & Rubino, F. (2009) · Endocrine Practice · doi:10.4158/ep09170.rar · Cited by 24

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)
ORCID: Egger, Joseph R.
Lee, Hongchan
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
DOI: 10.1210/jc.2007-2851
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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Effect of Weight Loss by Gastric Bypass Surgery Versus Hypocaloric Diet on Glucose and Incretin Levels in Patients with Type 2 Diabetes

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