scholarly journals Early and longer term effects of gastric bypass surgery on tissue-specific insulin sensitivity and beta cell function in morbidly obese patients with and without type 2 diabetes

Diabetologia ◽  
2011 ◽  
Vol 54 (8) ◽  
pp. 2093-2102 ◽  
Author(s):  
S. Camastra ◽  
A. Gastaldelli ◽  
A. Mari ◽  
S. Bonuccelli ◽  
G. Scartabelli ◽  
...  

2012 ◽  
Vol 256 (6) ◽  
pp. 1023-1029 ◽  
Author(s):  
Amanda Jiménez ◽  
Roser Casamitjana ◽  
Lílliam Flores ◽  
Judith Viaplana ◽  
Ricard Corcelles ◽  
...  




2015 ◽  
Vol 228 (1) ◽  
pp. 13-23 ◽  
Author(s):  
Xinrong Zhou ◽  
Bangguo Qian ◽  
Ning Ji ◽  
Conghui Lui ◽  
Zhiyuan Liu ◽  
...  

Gastric bypass surgery produces clear antidiabetic effects in a substantial proportion of morbidly obese patients. In view of the recent trend away from ‘bariatric’ surgery and toward ‘metabolic’ surgery, it is important to elucidate the enhancing effect of bypass surgery on pancreatic β-cell mass, which is related to diabetes remission in non-obese patients. We investigated the effects of gastric bypass surgery on glycemic control and other pancreatic changes in a spontaneous non-obese type 2 diabetes Goto-Kakizaki rat model. Significant improvements in postprandial hyperglycemia and plasma c-peptide level were observed when glucose was administered orally post-surgery. Other important events observed after surgery were enhanced first phase insulin secretion in a in site pancreatic perfusion experiment, pancreatic hyperplasia, improved islet structure (revealed by immunohistochemical analysis), striking increase in β-cell mass, slight increase in ratio of β-cell area to total pancreas area, and increased number of small islets closely related to exocrine ducts. No notable changes were observed in ratio of β-cell to non-β endocrine cell area, β-cell apoptosis, or β-cell proliferation. These findings demonstrate that gastric bypass surgery in this rat model increases endocrine cells and pancreatic hyperplasia, and reflect the important role of the gastrointestinal system in regulation of metabolism.



2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Mirella P. Hage ◽  
Bassem Safadi ◽  
Ibrahim Salti ◽  
Mona Nasrallah

Bariatric surgery is currently the most effective and durable therapy for obesity. Roux-en-Y gastric bypass surgery, the most commonly performed procedure worldwide, causes substantial weight loss and improvement in several comorbidities associated with obesity, especially type 2 diabetes. Several mechanisms are proposed to explain the improvement in glucose metabolism after RYGB surgery: the caloric restriction and weight loss per se, the improvement in insulin resistance and beta cell function, and finally the alterations in the various gastrointestinal hormones and adipokines that have been shown to play an important role in glucose homeostasis. However, the timing, exact changes of these hormones, and the relative importance of these changes in the metabolic improvement postbariatric surgery remain to be further clarified. This paper reviews the various changes post-RYGB in adipokines and gut peptides in subjects with T2D.



2019 ◽  
Vol 14 (4) ◽  
pp. 243-257
Author(s):  
Tummas Justinussen ◽  
Sten Madsbad ◽  
Jens Juul Holst ◽  
Kirstine Nyvold Bojsen-Møller




2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Petros Katsogiannos ◽  
Eva Randell ◽  
Magnus Sundbom ◽  
Andreas Rosenblad ◽  
Jan W. Eriksson ◽  
...  

Abstract Background To examine the effects of gastric bypass surgery on health-related quality of life (HRQoL) in obese patients with type 2 diabetes, and to investigate their experiences of life adjustments using quantitative and qualitative methods. Methods Thirteen patients with type 2 diabetes and obesity, (body mass index, BMI > 30 kg/m2), participating in a randomized clinical trial, completed this sub-study. HRQoL was evaluated before, and at 6 months and 2 years after gastric bypass surgery, using the RAND- 36-item health survey. At 2 years, interviews for in-depth analysis of HRQoL changes were performed. Results Significant improvement was observed from baseline to 6 months for 2 of the eight health concepts, general health, and emotional well-being. At 2 years, improvements were also seen in physical functioning, energy/fatigue, as well as sustained improvements in general health and emotional well-being. Multiple regression analyses showed mostly non-significant associations between the magnitude of decrease in weight, BMI, and HbA1c during follow-up and improvement in HRQoL. The analyses from qualitative interviews supported a common latent theme “Finding a balance between the experience of the new body weight and self-confidence”. Conclusions The improved HRQoL after gastric bypass surgery in obese patients with type 2 diabetes was not explained specifically by the magnitude of weight loss, but rather by the participants achieving a state of union between body and consciousness. Trial registration ClinicalTrials.gov Identifier NCT02729246. Date of registration 6 April 2016 – Retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02729246?term=bariglykos&draw=2&rank=1





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