NDLI: Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes.

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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.

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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.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Tran, Hao Kovack, Betty McGinty, James Olivan, Blanca Yapp, Kimberly Bawa, Baani Lee, Hongchan Koshy, Ninan Laferrère, Blandine Colarusso, Antonia Teixeira, Julio Egger, Joseph R.
Description	Country affiliation: United States Author Affiliation: Laferrère B ( St. Lukes Roosevelt Hospital, Obesity Research Center, 1111 Amsterdam Avenue, New York, NY 10025, USA. BBL14@columbia.edu)
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 as the difference in insulin levels in response to oral and to an isoglycemic iv glucose load. RESULTS: At baseline, none of the outcome variables (fasting and stimulated values) were different between the GBP and diet groups. Total GLP-1 levels after oral glucose markedly increased six times (peak:17 +/- 6 to 112 +/- 54 pmol/liter; P < 0.001), and the incretin effect increased five times (9.4 +/- 27.5 to 44.8 +/- 12.7%; P < 0.001) after GBP, but not after diet. Postprandial glucose levels (P = 0.001) decreased more after GBP. CONCLUSIONS: These data suggest that early after GBP, the greater GLP-1 and GIP release and improvement of incretin effect are related not to weight loss but rather to the surgical procedure. This could be responsible for better diabetes outcome after GBP.
ISSN	0021972X
e-ISSN	19457197
DOI	10.1210/jc.2007-2851
Journal	The Journal of Clinical Endocrinology & Metabolism
Issue Number	7
Volume Number	93
Language	English
Publisher	Oxford University Press
Publisher Date	2008-07-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Blood Glucose Diabetes Mellitus, Type 2 Therapy Gastric Bypass Incretins Blood Obesity Weight Loss Diet, Reducing Gastric Inhibitory Polypeptide Glucagon Glucagon-like Peptide 1 Comparative Study Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Discipline Endocrinology Discipline Metabolism
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Endocrinology, Diabetes and Metabolism Clinical Biochemistry Biochemistry Endocrinology

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