The role of GLP-1 in postprandial glucose metabolism after bariatric surgery: a narrative review of human GLP-1 receptor antagonist studies

19 Citations (Scopus)

Abstract

The Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) bariatric procedures lead to remission or improvement of type 2 diabetes. A weight loss-independent augmentation of postprandial insulin secretion contributes to the improvement in glycemic control after RYGB and is associated with a ∼10-fold increase in plasma concentrations of the incretin hormone glucagon-like peptide-1 (GLP-1). However, the physiologic importance of the markedly increased postprandial GLP-1 secretion after RYGB has been much debated. The effect of GLP-1 receptor blockade after RYGB has been investigated in 12 studies. The studies indicate a shift toward a more prominent role for GLP-1 in postprandial β-cell function after RYGB. The effect of GLP-1 receptor antagonism on glucose tolerance after RYGB is more complex and is associated with important methodological challenges. The postprandial GLP-1 response is less enhanced after SG compared with RYGB. However, the effect of GLP-1 receptor blockade after SG has been examined in 1 study only and needs further investigation.

Original languageEnglish
JournalSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Volume17
Issue number7
Pages (from-to)1383-1391
Number of pages9
ISSN1550-7289
DOIs
Publication statusPublished - 1 Jul 2021

Keywords

  • Exendin
  • Glucagon-like peptide-1
  • Roux-en-Y gastric bypass
  • Sleeve gastrectomy

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