Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Immediate enhancement of first-phase insulin secretion and unchanged glucose effectiveness in patients with type 2 diabetes after Roux-en-Y gastric bypass

Research output: Contribution to journalJournal articleResearchpeer-review

  1. A sandwich ELISA for measurement of the primary glucagon-like peptide-1 metabolite

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Leukemia inhibitory factor increases glucose uptake in mouse skeletal muscle

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Direct effect of incretin hormones on glucose and glycerol metabolism and hemodynamics

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. The renal extraction and the natriuretic action of GLP-1 in humans depend on interaction with the GLP-1 receptor

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Fractionated free fatty acids and their relation to diabetes status after Roux-en-Y gastric bypass: A cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Nonalcoholic Fatty Liver Disease Impairs the Liver-Alpha Cell Axis Independent of Hepatic Inflammation and Fibrosis

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Roux-en-Y gastric bypass surgery (RYGB) in patients with type 2 diabetes often leads to early disease remission, and it is unknown to what extent this involves improved pancreatic β-cell function per se and/or enhanced insulin- and non-insulin-mediated glucose disposal (glucose effectiveness). We studied 30 obese patients, including 10 with type 2 diabetes, 8 with impaired glucose tolerance, and 12 with normal glucose tolerance before, 1 wk, and 3 mo after RYGB, using an intravenous glucose tolerance test (IVGTT) to estimate first-phase insulin response, insulin sensitivity (Si), and glucose effectiveness with Bergman's minimal model. In the fasting state, insulin sensitivity was estimated by HOMA-S and β-cell function by HOMA-β. Moreover, mixed-meal tests and oral GTTs were performed. In patients with type 2 diabetes, glucose levels normalized after RYGB, first-phase insulin secretion in response to iv glucose increased twofold, and HOMA-β already improved 1 wk postoperatively, with further enhancements at 3 mo. Insulin sensitivity increased in the liver (HOMA-S) at 1 wk and at 3 mo in peripheral tissues (Si), whereas glucose effectiveness did not improve significantly. During oral testing, GLP-1 responses and insulin secretion increased regardless of glucose tolerance. Therefore, in addition to increased insulin sensitivity and exaggerated postprandial GLP-1 levels, diabetes remission after RYGB involves early improvement of pancreatic β-cell function per se, reflected in enhanced first-phase insulin secretion to iv glucose and increased HOMA-β. A major role for improved glucose effectiveness after RYGB was not supported by this study.

Original languageEnglish
JournalA J P: Endocrinology and Metabolism (Online)
Volume308
Issue number6
Pages (from-to)E535-44
ISSN1522-1555
DOIs
Publication statusPublished - 15 Mar 2015

    Research areas

  • Adult, Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, Fasting, Gastric Bypass, Glucose Intolerance, Glucose Tolerance Test, Humans, Insulin, Middle Aged, Obesity, Postoperative Period

ID: 45569838