scholarly journals Preoperative β-cell function in patients with type 2 diabetes is important for the outcome of Roux-en-Y gastric bypass surgery

2015 ◽  
Vol 593 (14) ◽  
pp. 3123-3133 ◽  
Author(s):  
Michael Taulo Lund ◽  
Merethe Hansen ◽  
Stinna Skaaby ◽  
Sina Dalby ◽  
Mikael Støckel ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Cell Function ◽  
Gastric Bypass Surgery ◽  
Β Cell ◽  
Β Cell Function

scholarly journals Pre-intervention clinical determinants and measured β-cell function as predictors of type 2 diabetes remission after Roux-en-Y gastric bypass surgery

2021 ◽  
Author(s):  
Chanel Ligon ◽  
Ankit Shah ◽  
Malini Prasad ◽  
Blandine Laferrère
Keyword(s):  
Type 2 Diabetes ◽  
Bypass Surgery ◽  
Cell Function ◽  
Gastric Bypass Surgery ◽  
Diabetes Remission ◽  
Β Cell ◽  
Β Cell Function ◽  
Clinical Models ◽  
One Year

<u>Background:</u> Bariatric surgery results in improved glycemic control in individuals with type 2 diabetes. Single and clusters of clinical determinants have been identified as pre-surgery predictors of post-surgery diabetes remission. Our goal was to assess if the addition of measured pre-operative ß-cell function would improve established clinical models of prediction of diabetes remission. <p><u>Methods:</u> Pre-surgery clinical characteristics, metabolic markers, and ß-cell function after oral and intravenous (IV) glucose challenges were assessed in 73 individuals with severe obesity and type 2 diabetes and again one year after gastric bypass surgery. Single and multivariate analyses were conducted with pre-operative variables to determine best predictive models of remission.</p> <p><u>Results:</u> Pre-surgery ß-cell glucose sensitivity, a surrogate of ß-cell function, was negatively correlated with known diabetes duration, HbA1c, insulin use, and the diabetes remission scores DiaRem and Ad-DiaRem (all p <0.001). Measured ß-cell function after oral glucose was 1.6-fold greater than after IV glucose challenge, and more strongly correlated with pre-operative clinical and metabolic characteristics. The addition of pre-operative ß-cell function to clinical models containing well-defined diabetes remission scores did not improve the model’s ability to predict diabetes remission post-RYGB. </p> <p><u>Conclusions:</u> The addition of measured β-cell function does not add predictive value to defined clinical models of diabetes remission one year after surgical weight loss.</p>

scholarly journals Pre-intervention clinical determinants and measured β-cell function as predictors of type 2 diabetes remission after Roux-en-Y gastric bypass surgery

2021 ◽  
Author(s):  
Chanel Ligon ◽  
Ankit Shah ◽  
Malini Prasad ◽  
Blandine Laferrère
Keyword(s):  
Type 2 Diabetes ◽  
Bypass Surgery ◽  
Cell Function ◽  
Gastric Bypass Surgery ◽  
Diabetes Remission ◽  
Β Cell ◽  
Β Cell Function ◽  
Clinical Models ◽  
One Year

<u>Background:</u> Bariatric surgery results in improved glycemic control in individuals with type 2 diabetes. Single and clusters of clinical determinants have been identified as pre-surgery predictors of post-surgery diabetes remission. Our goal was to assess if the addition of measured pre-operative ß-cell function would improve established clinical models of prediction of diabetes remission. <p><u>Methods:</u> Pre-surgery clinical characteristics, metabolic markers, and ß-cell function after oral and intravenous (IV) glucose challenges were assessed in 73 individuals with severe obesity and type 2 diabetes and again one year after gastric bypass surgery. Single and multivariate analyses were conducted with pre-operative variables to determine best predictive models of remission.</p> <p><u>Results:</u> Pre-surgery ß-cell glucose sensitivity, a surrogate of ß-cell function, was negatively correlated with known diabetes duration, HbA1c, insulin use, and the diabetes remission scores DiaRem and Ad-DiaRem (all p <0.001). Measured ß-cell function after oral glucose was 1.6-fold greater than after IV glucose challenge, and more strongly correlated with pre-operative clinical and metabolic characteristics. The addition of pre-operative ß-cell function to clinical models containing well-defined diabetes remission scores did not improve the model’s ability to predict diabetes remission post-RYGB. </p> <p><u>Conclusions:</u> The addition of measured β-cell function does not add predictive value to defined clinical models of diabetes remission one year after surgical weight loss.</p>

scholarly journals Pancreatic hyperplasia after gastric bypass surgery in a GK rat model of non-obese type 2 diabetes

2015 ◽  
Vol 228 (1) ◽  
pp. 13-23 ◽  
Author(s):  
Xinrong Zhou ◽  
Bangguo Qian ◽  
Ning Ji ◽  
Conghui Lui ◽  
Zhiyuan Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Rat Model ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Cell Mass ◽  
Cell Area ◽  
Obese Patients ◽  
Β Cell

Gastric bypass surgery produces clear antidiabetic effects in a substantial proportion of morbidly obese patients. In view of the recent trend away from ‘bariatric’ surgery and toward ‘metabolic’ surgery, it is important to elucidate the enhancing effect of bypass surgery on pancreatic β-cell mass, which is related to diabetes remission in non-obese patients. We investigated the effects of gastric bypass surgery on glycemic control and other pancreatic changes in a spontaneous non-obese type 2 diabetes Goto-Kakizaki rat model. Significant improvements in postprandial hyperglycemia and plasma c-peptide level were observed when glucose was administered orally post-surgery. Other important events observed after surgery were enhanced first phase insulin secretion in a in site pancreatic perfusion experiment, pancreatic hyperplasia, improved islet structure (revealed by immunohistochemical analysis), striking increase in β-cell mass, slight increase in ratio of β-cell area to total pancreas area, and increased number of small islets closely related to exocrine ducts. No notable changes were observed in ratio of β-cell to non-β endocrine cell area, β-cell apoptosis, or β-cell proliferation. These findings demonstrate that gastric bypass surgery in this rat model increases endocrine cells and pancreatic hyperplasia, and reflect the important role of the gastrointestinal system in regulation of metabolism.

scholarly journals Role of Gut-Related Peptides and Other Hormones in the Amelioration of Type 2 Diabetes after Roux-en-Y Gastric Bypass Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Mirella P. Hage ◽  
Bassem Safadi ◽  
Ibrahim Salti ◽  
Mona Nasrallah
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Cell Function ◽  
Gastric Bypass Surgery ◽  
Gastrointestinal Hormones ◽  
Gut Peptides

Bariatric surgery is currently the most effective and durable therapy for obesity. Roux-en-Y gastric bypass surgery, the most commonly performed procedure worldwide, causes substantial weight loss and improvement in several comorbidities associated with obesity, especially type 2 diabetes. Several mechanisms are proposed to explain the improvement in glucose metabolism after RYGB surgery: the caloric restriction and weight loss per se, the improvement in insulin resistance and beta cell function, and finally the alterations in the various gastrointestinal hormones and adipokines that have been shown to play an important role in glucose homeostasis. However, the timing, exact changes of these hormones, and the relative importance of these changes in the metabolic improvement postbariatric surgery remain to be further clarified. This paper reviews the various changes post-RYGB in adipokines and gut peptides in subjects with T2D.

scholarly journals Exaggerated Glucagon-Like Peptide 1 Response Is Important for Improved β-Cell Function and Glucose Tolerance After Roux-en-Y Gastric Bypass in Patients With Type 2 Diabetes

Diabetes ◽  
2013 ◽  
Vol 62 (9) ◽  
pp. 3044-3052 ◽  
Author(s):  
Nils B. Jørgensen ◽  
Carsten Dirksen ◽  
Kirstine N. Bojsen-Møller ◽  
Siv H. Jacobsen ◽  
Dorte Worm ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Glucose Tolerance ◽  
Cell Function ◽  
Β Cell ◽  
Β Cell Function ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Gastrointestinal hormones and β-cell function after gastric bypass and sleeve gastrectomy: an RCT (Oseberg)

2021 ◽  
Author(s):  
Farhat Fatima ◽  
Jøran Hjelmesæth ◽  
Kåre Inge Birkeland ◽  
Gulseth Løvdal Hanne ◽  
Jens Kristoffer Hertel ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Cell Function ◽  
Gastrointestinal Hormones ◽  
Diabetes Remission ◽  
Β Cell ◽  
Post Surgery ◽  
Β Cell Function

Abstract Context Whether Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) differentially affect postprandial gastrointestinal hormones and β-cell function in type 2 diabetes remains unclear. Objective To compare gastrointestinal hormones and β-cell function assessed by an oral glucose tolerance test (OGTT) 5 weeks and 1 year after surgery hypothesizing higher GLP-1 levels and greater β-cell response to glucose after RYGB than after SG. Design, Setting, Patients, and Interventions Randomized, triple blind, single-center trial at a tertiary care center in Norway. Primary outcomes; diabetes remission and IVGTT derived β-cell function. Participants with obesity and type 2 diabetes allocated (1:1) to RYGB or SG. Main outcome measures Gastrointestinal hormone profiles and insulin secretion [β-cell glucose sensitivity (β-GS)] derived from 180 minutes OGTTs. Results 106 patients (67% women), mean (SD) age 48 (10) years. Diabetes remission rates at 1-year were higher after RYGB than after SG, 77% versus 48%, p = 0.002. Incremental area under the curve (iAUC0-180) glucagon-like peptide-1 (GLP-1) and β-GS increased more after RYGB than after SG, 1-year between-group difference 1173 pmol/l*min (95% CI 569 to 1776), p = 0.0010, and 0.45 pmol/kg/min/mmol (95% CI 0.15 to 0.75), p = 0.0032, respectively. Post-surgery, fasting and postprandial ghrelin levels were higher and decremental AUC0-180 ghrelin, iAUC0-180 glucose-dependent insulinotropic polypeptide, and iAUC0-60 glucagon were greater after RYGB than after SG. Diabetes remission at 1 year was associated with higher β-GS and higher GLP-1 secretion. Conclusions RYGB was associated with greater improvement in β-cell function and higher postprandial GLP-1 levels than SG.

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