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Early mechanisms of glucose improvement following laparoscopic ileal interposition associated with a sleeve gastrectomy evaluated by the euglycemic hyperinsulinemic clamp in type 2 diabetic patients with BMI below 35.
- Source :
-
Digestive surgery [Dig Surg] 2011; Vol. 28 (4), pp. 293-8. Date of Electronic Publication: 2011 Sep 01. - Publication Year :
- 2011
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Abstract
- Background: Laparoscopic ileal interposition associated with a sleeve gastrectomy (LII-SG) is a safe and effective operation for the treatment of type 2 diabetic (T2DM) patients with BMI below 35. The aim of this study was to evaluate insulin sensitivity (IS) and β-cell function using the euglycemic hyperinsulinemic clamp (EHC) with the intravenous glucose tolerance test (IVGTT).<br />Methods: This was a prospective study of 24 T2DM patients submitted to a 3-hour EHC-IVGTT before and 1 month after LII-SG. Mean BMI was 29.0, mean age was 54.8 years and mean duration of T2DM was 10.2 years; insulin therapy was used by 62.5% of the patients.<br />Results: Mean BMI decreased from 29.0 to 25.8 (p < 0.001). Mean fasting plasma glucose and mean postprandial glucose were 202 and 251.3 mg/dl and dropped to 127.7 and 131.8 mg/dl (p < 0.001), respectively. Mean preoperative IS was 1.4 mmol·min(-1)·nmol(-1) and increased to 2.2 mmol· min(-1)·nmol(-1) postoperatively (p < 0.001). Mean C-peptide AUC was 488 pmol·nmol(-1) and increased to 777 pmol· nmol(-1) (p = 0.37). The disposition index increased from 9.4 to 36.4 postoperatively (p = 0.01).<br />Conclusions: According to the clamp technique, II-SG significantly improved IS and β-cell function as early as 30 days postoperatively in a T2DM population with a BMI of 21.9-33.8.<br /> (Copyright © 2011 S. Karger AG, Basel.)
- Subjects :
- Adult
Area Under Curve
Bariatric Surgery
Body Mass Index
C-Peptide blood
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 surgery
Female
Glucose Clamp Technique
Glucose Tolerance Test
Humans
Insulin blood
Laparoscopy
Male
Middle Aged
Obesity blood
Obesity physiopathology
Obesity surgery
Postoperative Period
Preoperative Period
Prospective Studies
Weight Loss
Blood Glucose metabolism
Diabetes Mellitus, Type 2 physiopathology
Gastrectomy
Ileum surgery
Insulin Resistance physiology
Insulin-Secreting Cells physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9883
- Volume :
- 28
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Digestive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 21894016
- Full Text :
- https://doi.org/10.1159/000330272