Changes of blood glucose and gastrointestinal hormones 4 months after Roux-en-Y gastric bypass surgery in Chinese obese type 2 diabetes patients with lower body mass index

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.

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Effect of Modified Roux-en-Y Gastric Bypass Surgery on GLP-1, GIP in Patients with Type 2 Diabetes Mellitus

Gastroenterology Research and Practice ◽

10.1155/2015/625196 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Shao-Wei Xiong ◽

Jing Cao ◽

Xian-Ming Liu ◽

Xing-Ming Deng ◽

Zeng Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Gastric Bypass ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Control Blood Glucose ◽

Therapeutic Mechanism

The type 2 diabetes mellitus (T2DM) is one of the most serious diseases that threaten public health. Modified gastric bypass surgery has been applied to the treatment of T2DM patients in the 1990s, but the therapeutic mechanism to this function is still unclear. The aim of this study was to further clarify the effect and the mechanism of modified gastric bypass surgery on glucose metabolism in patients with T2DM. In the study, the incretin indexes and blood glucose indexes were analyzed before surgery and 1 week and 1, 3, and 6 months after surgery. The results suggested that modified Roux-en-Y gastric bypass can promote GLP-1 secretion in patients with T2DM, while reducing the secretion of GIP. Thus it could effectively control blood glucose of patients with T2DM.

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Insulin in the Medical Management of Postprandial Hypoglycemia in a Patient with Type 2 Diabetes after Gastric Bypass Surgery

Case Reports in Endocrinology ◽

10.1155/2012/427565 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4

Author(s):

Jennifer Leung Schoenberger ◽

Chung-Kay Koh ◽

Tiffany Hor ◽

David Baldwin ◽

Arati Reddy ◽

...

Keyword(s):

Type 2 Diabetes ◽

Gastric Bypass ◽

Insulin Secretion ◽

Blood Glucose ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Glucose Monitoring ◽

Postprandial Hyperglycemia ◽

Calcium Stimulation

Objective. We evaluated a 47-year-old woman with a history of type 2 diabetes and severe obesity who developed postprandial hypoglycemia after undergoing Roux-en-Y gastric bypass surgery and losing 60% of her total body weight. We studied her insulin secretion and blood glucose dynamics and were able to tailor a therapeutic regimen involving insulin that eliminated episodes of hypoglycemia.Methods. We studied blood glucose levels during a prolonged fast, performed continuous glucose monitoring studies using a subcutaneous glucose sensor, and evaluated regional pancreatic insulin secretion using selective arterial calcium stimulation.Results. Continuous glucose monitoring revealed that the patient had early (1-2 hr) postprandial hyperglycemia followed by late (3-4 hr) postprandial hypoglycemia. Biochemical studies confirmed endogenous pancreatogenous insulin secretion as the cause of episodic hypoglycemia, but imaging studies and selective arterial calcium stimulation failed to localize an insulinoma. The patient was treated with preprandial doses of insulin aspart in order to attenuate the early postprandial hyperglycemia, and the late hypoglycemic episodes were avoided.Conclusion. We describe an interesting and novel nonsurgical approach to the prevention of postprandial hypoglycemia in a patient with noninsulinoma pancreatogenous hypoglycemia after gastric bypass.

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