التفاصيل البيبلوغرافية
| العنوان: |
Prospective evaluation of insulin and incretin dynamics in obese adults with and without diabetes for 2 years after Roux-en-Y gastric bypass |
| المؤلفون: |
Purnell, Jonathan Q, Johnson, Geoffrey S, Wahed, Abdus S, Dalla Man, Chiara, Piccinini, Francesca, Cobelli, Claudio, Prigeon, Ronald L, Goodpaster, Bret H, Kelley, David E, Staten, Myrlene A, Foster-Schubert, Karen E, Cummings, David E, Flum, David R, Courcoulas, Anita P, Havel, Peter J, Wolfe, Bruce M |
| المصدر: |
Diabetologia, vol 61, iss 5 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2018 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Biomedical and Clinical Sciences, Clinical Sciences, Diabetes, Prevention, Nutrition, Clinical Research, Digestive Diseases, Obesity, 2.1 Biological and endogenous factors, Aetiology, Metabolic and endocrine, Adult, Diabetes Mellitus, Female, Gastric Bypass, Humans, Incretins, Insulin, Islets of Langerhans, Longitudinal Studies, Male, Middle Aged, Postoperative Period, Prospective Studies, Remission Induction, Time Factors, Weight Loss, Disposition index, Frequently-sampled intravenous glucose tolerance test, GIP |
| الوقت: |
1142 - 1154 |
| الوصف: |
Aims/hypothesisIn this prospective case-control study we tested the hypothesis that, while long-term improvements in insulin sensitivity (SI) accompanying weight loss after Roux-en-Y gastric bypass (RYGB) would be similar in obese individuals with and without type 2 diabetes mellitus, stimulated-islet-cell insulin responses would differ, increasing (recovering) in those with diabetes but decreasing in those without. We investigated whether these changes would occur in conjunction with favourable alterations in meal-related gut hormone secretion and insulin processing.MethodsForty participants with type 2 diabetes and 22 participants without diabetes from the Longitudinal Assessment of Bariatric Surgery (LABS-2) study were enrolled in a separate, longitudinal cohort (LABS-3 Diabetes) to examine the mechanisms of postsurgical diabetes improvement. Study procedures included measures of SI, islet secretory response and gastrointestinal hormone secretion after both intravenous glucose (frequently-sampled IVGTT [FSIVGTT]) and a mixed meal (MM) prior to and up to 24months after RYGB.ResultsPostoperatively, weight loss and SI-FSIVGTT improvement was similar in both groups, whereas the acute insulin response to glucose (AIRglu) decreased in the non-diabetic participants and increased in the participants with type 2 diabetes. The resulting disposition indices (DIFSIVGTT) increased by three- to ninefold in both groups. In contrast, during the MM, total insulin responsiveness did not significantly change in either group despite durable increases of up to eightfold in postprandial glucagon-like peptide 1 levels, and SI-MM and DIMM increased only in the diabetes group. Peak postprandial glucagon levels increased in both groups.Conclusions/interpretationFor up to 2years following RYGB, obese participants without diabetes showed improvements in DI that approach population norms. Those with type 2 diabetes recovered islet-cell insulin secretion response yet continued to manifest abnormal insulin processing, with DI values that ... |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt7km8632j; https://escholarship.org/uc/item/7km8632jTest |
| الإتاحة: |
https://escholarship.org/uc/item/7km8632jTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.B20EEBD8 |
| قاعدة البيانات: |
BASE |
