Journal article
GLP-1 Plays a Limited Role in Improved Glycemia Shortly After Roux-en-Y Gastric Bypass: A Comparison With Intensive Lifestyle Modification
Diabetes (New York, N.Y.), v 64(2), pp 434-446
01 Feb 2015
PMID: 25204975
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Rapid glycemic improvements following Roux-en-Y gastric bypass (RYGB) are frequently attributed to the enhanced GLP-1 response, but causality remains unclear. To determine the role of GLP-1 in improved glucose tolerance after surgery, we compared glucose and hormonal responses to a liquid meal test in 20 obese participants with type 2 diabetes mellitus who underwent RYGB or nonsurgical intensive lifestyle modification (ILM) (n = 10 per group) before and after equivalent short-term weight reduction. The GLP-1 receptor antagonist exendin((9-39))-amide (Ex-9) was administered, in random order and in double-blinded fashion, with saline during two separate visits after equivalent weight loss. Despite the markedly exaggerated GLP-1 response after RYGB, changes in postprandial glucose and insulin responses did not significantly differ between groups, and glucagon secretion was paradoxically augmented after RYGB. Hepatic insulin sensitivity also increased significantly after RYGB. With Ex-9, glucose tolerance deteriorated similarly from the saline condition in both groups, but postprandial insulin release was markedly attenuated after RYGB compared with ILM. GLP-1 exerts important insulinotropic effects after RYGB and ILM, but the enhanced incretin response plays a limited role in improved glycemia shortly after surgery. Instead, enhanced hepatic metabolism, independent of GLP-1 receptor activation, may be more important for early post-surgical glycemic improvements.
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Details
- Title
- GLP-1 Plays a Limited Role in Improved Glycemia Shortly After Roux-en-Y Gastric Bypass: A Comparison With Intensive Lifestyle Modification
- Creators
- Marion L. Vetter - University of PennsylvaniaThomas A. Wadden - University of PennsylvaniaKaren L. Teff - Monell Chemical Senses CenterZahra F. Khan - MED InstituteRaymond Carvajal - University of PennsylvaniaScott Ritter - University of PennsylvaniaRenee H. Moore - North Carolina State UniversityJesse L. Chittams - University of PennsylvaniaAlex Iagnocco - North Carolina State UniversityKenric Murayama - University of PennsylvaniaGary Korus - University of PennsylvaniaNoel N. Williams - University of PennsylvaniaMichael R. Rickels - University of Pennsylvania
- Publication Details
- Diabetes (New York, N.Y.), v 64(2), pp 434-446
- Publisher
- Amer Diabetes Assoc
- Number of pages
- 13
- Grant note
- UL1RR024134 / Penn Clinical and Translational Research Center KL2RR024132 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) P30DK019525 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) KL2RR024132 / Penn Institute for Translational Medicine and Therapeutics P30DK19525 / Penn Diabetes Research Center
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics; Surgery
- Web of Science ID
- WOS:000348827100015
- Scopus ID
- 2-s2.0-84921903924
- Other Identifier
- 991021448189004721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Endocrinology & Metabolism