The effects of diet- and RYGB-induced weight loss on insulin sensitivity in obese patients with and without type 2 diabetes

Merethe Hansen, Michael Taulo Lund, Anne Line Kjærholm Jørgensen, Marie Kroman Palsøe, Gerrit van Hall, Jørn Wulff Helge, Flemming Dela

9 Citations (Scopus)

Abstract

AIMS: The impact of diet-induced weight loss and weight loss due to RYGB in patients with (T2DM, N = 16) and without (OB, N = 27) type 2 diabetes was studied.

METHODS: At inclusion (A), after diet-induced weight loss (B), 4 months post-surgery (C) and 18 months post-surgery (D) body composition, hepatic glucose production (HGP), insulin-mediated glucose uptake (GIR), respiratory exchange ratio, hepatic insulin sensitivity and clearance were determined. GLUT4, intramuscular triglycerides (IMTG) and glycogen content were measured in skeletal muscle.

RESULTS: Weight loss was 35-40 kg, and approximately one-third of the total improvement in GIR in T2DM was observed after the diet-induced weight loss of only ~6 kg (B). Insulin clearance, visceral fat and fasting plasma insulin also improved significantly after the diet (P < 0.05). Throughout the study, HGP, GLUT4 and glycogen content did not change significantly, but IMTG decreased significantly consistent with significant increases in GIR. Metabolic flexibility and hepatic insulin sensitivity improved after RYGB.

CONCLUSIONS: Metabolic improvements of RYGB are present already after the diet-induced weight loss prior to surgery. GLUT4 content in skeletal muscle cannot and IMTG content can only partly explain increases in GIR after RYGB.

Original languageEnglish
JournalActa Diabetologica
Volume53
Issue number3
Pages (from-to)423-32
Number of pages10
ISSN0940-5429
DOIs
Publication statusPublished - Jun 2016

Keywords

  • Adult
  • Blood Glucose
  • Diabetes Mellitus, Type 2
  • Diet, Reducing
  • Female
  • Gastric Bypass
  • Glycogen
  • Humans
  • Insulin
  • Insulin Resistance
  • Male
  • Obesity
  • Triglycerides
  • Weight Loss
  • Journal Article

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