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Sustained Improvements in Glucose Metabolism Late After Roux-En-Y Gastric Bypass Surgery in Patients with and Without Preoperative Diabetes
- Source :
- Scientific Reports, Scientific Reports, Vol 9, Iss 1, Pp 1-10 (2019), Jørgensen, N B, Bojsen-Møller, K N, Dirksen, C, Martinussen, C, Svane, M S, Kristiansen, V B, Holst, J J & Madsbad, S 2019, ' Sustained Improvements in Glucose Metabolism Late After Roux-En-Y Gastric Bypass Surgery in Patients with and Without Preoperative Diabetes ', Scientific Reports, vol. 9, no. 1, 15154 . https://doi.org/10.1038/s41598-019-51516-y
- Publication Year :
- 2019
- Publisher :
- Nature Publishing Group UK, 2019.
-
Abstract
- To describe glucose metabolism in the late, weight stable phase after Roux-en-Y Gastric Bypass (RYGB) in patients with and without preoperative type 2 diabetes we invited 55 RYGB-operated persons from two existing cohorts to participate in a late follow-up study. 44 (24 with normal glucose tolerance (NGT)/20 with type 2 diabetes (T2D) before surgery) accepted the invitation (median follow-up 2.7 [Range 2.2–5.0 years]). Subjects were examined during an oral glucose stimulus and results compared to preoperative and 1-year (1 y) post RYGB results. Glucose tolerance, insulin resistance, beta-cell function and incretin hormone secretion were evaluated. 1 y weight loss was maintained late after surgery. Glycemic control, insulin resistance, beta-cell function and GLP-1 remained improved late after surgery in both groups. In NGT subjects, nadir glucose decreased 1 y after RYGB, but did not change further. In T2D patients, relative change in weight from 1 y to late after RYGB correlated with relative change in fasting glucose and HbA1c, whereas relative changes in glucose-stimulated insulin release correlated inversely with relative changes in postprandial glucose excursions. In NGT subjects, relative changes in postprandial nadir glucose correlated with changes in beta-cell glucose sensitivity. Thus, effects of RYGB on weight and glucose metabolism are maintained late after surgery in patients with and without preoperative T2D. Weight loss and improved beta-cell function both contribute to maintenance of long-term glycemic control in patients with type 2 diabetes, and increased glucose stimulated insulin secretion may contribute to postprandial hypoglycemia in NGT subjects.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
endocrine system diseases
medicine.medical_treatment
Science
Gastric Bypass
030209 endocrinology & metabolism
Type 2 diabetes
medicine.disease_cause
Gastroenterology
Incretins
Article
03 medical and health sciences
0302 clinical medicine
Insulin resistance
Weight loss
Diabetes mellitus
Internal medicine
Insulin-Secreting Cells
Insulin Secretion
Weight Loss
medicine
Humans
Obesity
Glycemic
Multidisciplinary
business.industry
Gastric bypass surgery
Insulin
Body Weight
nutritional and metabolic diseases
Middle Aged
medicine.disease
030104 developmental biology
Postprandial
Glucose
Diabetes Mellitus, Type 2
Medicine
Female
medicine.symptom
Insulin Resistance
business
Subjects
Details
- Language :
- English
- ISSN :
- 20452322
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Scientific Reports
- Accession number :
- edsair.doi.dedup.....409416a328883da73761e753c9489a2b