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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

TLDR
Early after Gastric bypass surgery, the greater GLP-1 and GIP release and improvement of incretin effect are related not to weight loss but rather to the surgical procedure, which could be responsible for better diabetes outcome after GBP.
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...

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Journal ArticleDOI

Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes

TL;DR: In severely obese patients with type 2 diabetes, bariatric surgery resulted in better glucose control than did medical therapy and preoperative BMI and weight loss did not predict the improvement in hyperglycemia after these procedures.
Journal ArticleDOI

European Guidelines for Obesity Management in Adults

TL;DR: It is concluded that physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment and focus on realistic goals and lifelong multidisciplinary management.
Journal ArticleDOI

Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol

TL;DR: Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone, and was associated with decreased pancreatic and liver triacylglycerol stores.
References
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Journal ArticleDOI

Bariatric surgery: a systematic review and meta-analysis.

TL;DR: Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery, and a substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.
Journal ArticleDOI

Prevalence of overweight and obesity among us children, adolescents, and adults, 1999-2002

TL;DR: The NHANES results indicate continuing disparities by sex and between racial/ethnic groups in the prevalence of overweight and obesity among adults and overweight among children, using the most recent national data of height and weight measurements.
Journal ArticleDOI

The Physiology of Glucagon-like Peptide 1

TL;DR: The main actions of GLP-1 are to stimulate insulin secretion and to inhibit glucagon secretion, thereby contributing to limit postprandial glucose excursions and acts as an enterogastrone and part of the "ileal brake" mechanism.
Journal ArticleDOI

Bariatric surgery. A systematic review and meta-analysis

TL;DR: Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery, and a substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.
Journal ArticleDOI

Reduced incretin effect in type 2 (non-insulin-dependent) diabetes.

TL;DR: Integrated incremental immunoreactive insulin and connecting peptide responses to an oral glucose load and an “isoglycaemic” intravenous glucose infusion, respectively, were measured in 14 Type 2 diabetic patients and 8 age- and weight-matched metabolically healthy control subjects.
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