Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgery

Mousumi Bose, Julio Teixeira, Blanca Olivan, Baani Bawa, Sara Arias, Sriram Machineni, F. Xavier Pi-Sunyer, Philipp E. Scherer, Blandine Laferrè

Research output: Contribution to journalArticleResearchpeer-review

76 Citations (Scopus)

Abstract

Background: The aim of the present study was to determine the mechanisms underlying Type 2 diabetes remission after gastric bypass (GBP) surgery by characterizing the short- and long-term changes in hormonal determinants of blood glucose. Methods: Eleven morbidly obese women with diabetes were studied before and 1, 6, and 12 months after GBP; eight non-diabetic morbidly obese women were used as controls. The incretin effect was measured as the difference in insulin levels in response to oral glucose and to an isoglycemic intravenous challenge. Outcome measures were glucose, insulin, C-peptide, proinsulin, amylin, glucagon, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1) levels and the incretin effect on insulin secretion. Results: The decrease in fasting glucose (r = 0.724) and insulin (r = 0.576) was associated with weight loss up to 12 months after GBP. In contrast, the blunted incretin effect (calculated at 22%) that improved at 1 month remained unchanged with further weight loss at 6 (52%) and 12 (52%) months. The blunted incretin (GLP-1 and GIP) levels, early phase insulin secretion, and other parameters of β-cell function (amylin, proinsulin ? insulin) followed the same pattern, with rapid improvement at 1 month that remained unchanged at 1 year. Conclusions: The data suggest that weight loss and incretins may contribute independently to improved glucose levels in the first year after GBP surgery.

Original languageEnglish
Pages (from-to)47-55
Number of pages9
JournalJournal of Diabetes
Volume2
Issue number1
DOIs
StatePublished - 19 Mar 2010

Fingerprint

Incretins
Gastric Bypass
Weight Loss
Insulin
Glucose
Islet Amyloid Polypeptide
Glucagon-Like Peptide 1
Proinsulin
Peptides
C-Peptide
Glucagon
Type 2 Diabetes Mellitus
Blood Glucose
Fasting
Outcome Assessment (Health Care)

Keywords

  • Gastric bypass
  • Glucagon-like peptide-1
  • Glucose-dependent insulinotropic polypeptide
  • Incretins

Cite this

Bose, Mousumi ; Teixeira, Julio ; Olivan, Blanca ; Bawa, Baani ; Arias, Sara ; Machineni, Sriram ; Pi-Sunyer, F. Xavier ; Scherer, Philipp E. ; Laferrè, Blandine. / Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgery. In: Journal of Diabetes. 2010 ; Vol. 2, No. 1. pp. 47-55.
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abstract = "Background: The aim of the present study was to determine the mechanisms underlying Type 2 diabetes remission after gastric bypass (GBP) surgery by characterizing the short- and long-term changes in hormonal determinants of blood glucose. Methods: Eleven morbidly obese women with diabetes were studied before and 1, 6, and 12 months after GBP; eight non-diabetic morbidly obese women were used as controls. The incretin effect was measured as the difference in insulin levels in response to oral glucose and to an isoglycemic intravenous challenge. Outcome measures were glucose, insulin, C-peptide, proinsulin, amylin, glucagon, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1) levels and the incretin effect on insulin secretion. Results: The decrease in fasting glucose (r = 0.724) and insulin (r = 0.576) was associated with weight loss up to 12 months after GBP. In contrast, the blunted incretin effect (calculated at 22{\%}) that improved at 1 month remained unchanged with further weight loss at 6 (52{\%}) and 12 (52{\%}) months. The blunted incretin (GLP-1 and GIP) levels, early phase insulin secretion, and other parameters of β-cell function (amylin, proinsulin ? insulin) followed the same pattern, with rapid improvement at 1 month that remained unchanged at 1 year. Conclusions: The data suggest that weight loss and incretins may contribute independently to improved glucose levels in the first year after GBP surgery.",
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Bose, M, Teixeira, J, Olivan, B, Bawa, B, Arias, S, Machineni, S, Pi-Sunyer, FX, Scherer, PE & Laferrè, B 2010, 'Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgery', Journal of Diabetes, vol. 2, no. 1, pp. 47-55. https://doi.org/10.1111/j.1753-0407.2009.00064.x

Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgery. / Bose, Mousumi; Teixeira, Julio; Olivan, Blanca; Bawa, Baani; Arias, Sara; Machineni, Sriram; Pi-Sunyer, F. Xavier; Scherer, Philipp E.; Laferrè, Blandine.

In: Journal of Diabetes, Vol. 2, No. 1, 19.03.2010, p. 47-55.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgery

AU - Bose, Mousumi

AU - Teixeira, Julio

AU - Olivan, Blanca

AU - Bawa, Baani

AU - Arias, Sara

AU - Machineni, Sriram

AU - Pi-Sunyer, F. Xavier

AU - Scherer, Philipp E.

AU - Laferrè, Blandine

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N2 - Background: The aim of the present study was to determine the mechanisms underlying Type 2 diabetes remission after gastric bypass (GBP) surgery by characterizing the short- and long-term changes in hormonal determinants of blood glucose. Methods: Eleven morbidly obese women with diabetes were studied before and 1, 6, and 12 months after GBP; eight non-diabetic morbidly obese women were used as controls. The incretin effect was measured as the difference in insulin levels in response to oral glucose and to an isoglycemic intravenous challenge. Outcome measures were glucose, insulin, C-peptide, proinsulin, amylin, glucagon, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1) levels and the incretin effect on insulin secretion. Results: The decrease in fasting glucose (r = 0.724) and insulin (r = 0.576) was associated with weight loss up to 12 months after GBP. In contrast, the blunted incretin effect (calculated at 22%) that improved at 1 month remained unchanged with further weight loss at 6 (52%) and 12 (52%) months. The blunted incretin (GLP-1 and GIP) levels, early phase insulin secretion, and other parameters of β-cell function (amylin, proinsulin ? insulin) followed the same pattern, with rapid improvement at 1 month that remained unchanged at 1 year. Conclusions: The data suggest that weight loss and incretins may contribute independently to improved glucose levels in the first year after GBP surgery.

AB - Background: The aim of the present study was to determine the mechanisms underlying Type 2 diabetes remission after gastric bypass (GBP) surgery by characterizing the short- and long-term changes in hormonal determinants of blood glucose. Methods: Eleven morbidly obese women with diabetes were studied before and 1, 6, and 12 months after GBP; eight non-diabetic morbidly obese women were used as controls. The incretin effect was measured as the difference in insulin levels in response to oral glucose and to an isoglycemic intravenous challenge. Outcome measures were glucose, insulin, C-peptide, proinsulin, amylin, glucagon, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1) levels and the incretin effect on insulin secretion. Results: The decrease in fasting glucose (r = 0.724) and insulin (r = 0.576) was associated with weight loss up to 12 months after GBP. In contrast, the blunted incretin effect (calculated at 22%) that improved at 1 month remained unchanged with further weight loss at 6 (52%) and 12 (52%) months. The blunted incretin (GLP-1 and GIP) levels, early phase insulin secretion, and other parameters of β-cell function (amylin, proinsulin ? insulin) followed the same pattern, with rapid improvement at 1 month that remained unchanged at 1 year. Conclusions: The data suggest that weight loss and incretins may contribute independently to improved glucose levels in the first year after GBP surgery.

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KW - Glucagon-like peptide-1

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