78-OR: Glycaemia, Beta-Cell Function, and Incretin Hormones Post-OGTT One Year after Gastric Bypass and Sleeve Gastrectomy in Patients with Morbid Obesity and Type 2 Diabetes: An RCT (Oseberg Study)

Abstract To describe glucose metabolism in the late, weight stable phase after Roux-en-Y Gastric Bypass (RYGB) in patients with and without preoperative type 2 diabetes we invited 55 RYGB-operated persons from two existing cohorts to participate in a late follow-up study. 44 (24 with normal glucose tolerance (NGT)/20 with type 2 diabetes (T2D) before surgery) accepted the invitation (median follow-up 2.7 [Range 2.2–5.0 years]). Subjects were examined during an oral glucose stimulus and results compared to preoperative and 1-year (1 y) post RYGB results. Glucose tolerance, insulin resistance, beta-cell function and incretin hormone secretion were evaluated. 1 y weight loss was maintained late after surgery. Glycemic control, insulin resistance, beta-cell function and GLP-1 remained improved late after surgery in both groups. In NGT subjects, nadir glucose decreased 1 y after RYGB, but did not change further. In T2D patients, relative change in weight from 1 y to late after RYGB correlated with relative change in fasting glucose and HbA1c, whereas relative changes in glucose-stimulated insulin release correlated inversely with relative changes in postprandial glucose excursions. In NGT subjects, relative changes in postprandial nadir glucose correlated with changes in beta-cell glucose sensitivity. Thus, effects of RYGB on weight and glucose metabolism are maintained late after surgery in patients with and without preoperative T2D. Weight loss and improved beta-cell function both contribute to maintenance of long-term glycemic control in patients with type 2 diabetes, and increased glucose stimulated insulin secretion may contribute to postprandial hypoglycemia in NGT subjects.

Download Full-text

Biliopancreatic diversion with duodenal switch leads to better postprandial glucose level and beta cell function than sleeve gastrectomy in individuals with type 2 diabetes very early after surgery

Metabolism ◽

10.1016/j.metabol.2017.06.005 ◽

2017 ◽

Vol 74 ◽

pp. 10-21 ◽

Cited By ~ 13

Author(s):

Andréanne Michaud ◽

Thomas Grenier-Larouche ◽

Dominique Caron-Dorval ◽

Simon Marceau ◽

Laurent Biertho ◽

...

Keyword(s):

Type 2 Diabetes ◽

Sleeve Gastrectomy ◽

Beta Cell ◽

Biliopancreatic Diversion ◽

Beta Cell Function ◽

Duodenal Switch ◽

Cell Function ◽

Postprandial Glucose ◽

Postprandial Glucose Level

Download Full-text

Insulin resistance and beta cell function before and after sleeve gastrectomy in obese patients with impaired fasting glucose or type 2 diabetes

Surgical Endoscopy ◽

10.1007/s00464-014-3675-7 ◽

2014 ◽

Vol 29 (2) ◽

pp. 438-443 ◽

Cited By ~ 11

Author(s):

Hans Eickhoff ◽

Ana Guimarães ◽

Teresa M. Louro ◽

Raquel M. Seiça ◽

Francisco Castro e Sousa

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Sleeve Gastrectomy ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Fasting Glucose ◽

Obese Patients ◽

Before And After

Download Full-text

The Recovery of Beta-Cell Function is Critical for Antidiabetic Outcomes of Gastric Bypass in Asian Subjects with Type 2 Diabetes and a Body Mass Index Below 30

Obesity Surgery ◽

10.1007/s11695-016-2455-y ◽

2016 ◽

Vol 27 (2) ◽

pp. 541-544 ◽

Cited By ~ 3

Author(s):

Obin Kwon ◽

Yeon Ji Lee ◽

Ji Hee Yu ◽

Min-Seon Kim ◽

Yoonseok Heo

Keyword(s):

Type 2 Diabetes ◽

Body Mass Index ◽

Gastric Bypass ◽

Beta Cell ◽

Body Mass ◽

Beta Cell Function ◽

Cell Function

Download Full-text

Single-centre, triple-blinded, randomised, 1-year, parallel-group, superiority study to compare the effects of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function in subjects with morbid obesity: a protocol for the Obesitysurgery in Tønsberg(Oseberg) study

BMJ Open ◽

10.1136/bmjopen-2018-024573 ◽

2019 ◽

Vol 9 (6) ◽

pp. e024573 ◽

Cited By ~ 4

Author(s):

Heidi Borgeraas ◽

Jøran Hjelmesæth ◽

Kåre Inge Birkeland ◽

Farhat Fatima ◽

John Olav Grimnes ◽

...

Keyword(s):

Type 2 Diabetes ◽

Morbid Obesity ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Cell Function ◽

Single Centre ◽

Β Cell ◽

Β Cell Function ◽

Diabetes And Obesity

IntroductionBariatric surgery is increasingly recognised as an effective treatment option for subjects with type 2 diabetes and obesity; however, there is no conclusive evidence on the superiority of Roux-en-Y gastric bypass or sleeve gastrectomy. The Oseberg study was designed to compare the effects of gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function.Methods and analysisSingle-centre, randomised, triple-blinded, two-armed superiority trial carried out at the Morbid Obesity Centre at Vestfold Hospital Trust in Norway. Eligible patients with type 2 diabetes and obesity were randomly allocated in a 1:1 ratio to either gastric bypass or sleeve gastrectomy. The primary outcome measures are (1) the proportion of participants with complete remission of type 2 diabetes (HbA1c≤6.0% in the absence of blood glucose-lowering pharmacologic therapy) and (2) β-cell function expressed by the disposition index (calculated using the frequently sampled intravenous glucose tolerance test with minimal model analysis) 1 year after surgery.Ethics and disseminationThe protocol of the current study was reviewed and approved by the regional ethics committee on 12 September 2012 (ref: 2012/1427/REK sør-øst B). The results will be disseminated to academic and health professional audiences and the public via publications in international peer-reviewed journals and conferences. Participants will receive a summary of the main findings.Trial registration numberNCT01778738;Pre-results.

Download Full-text

Type 2 diabetes remission one year after bariatric surgery - a comparison between vertical sleeve gastrectomy and gastric bypass

Endocrine Abstracts ◽

10.1530/endoabs.56.gp102 ◽

2018 ◽

Author(s):

Ines Ferreira Barros ◽

Silvia Paredes ◽

Fernando Manso ◽

Costa Jose Manuel Maia da ◽

Aline Fernandes ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Diabetes Remission ◽

Vertical Sleeve Gastrectomy ◽

Type 2 Diabetes Remission ◽

One Year

Download Full-text

Blood intact incretin levels are related to beta-cell function and glycemia in patients with type 2 diabetes

Endocrine Abstracts ◽

10.1530/endoabs.63.gp201 ◽

2019 ◽

Author(s):

Yeekyoung Ko ◽

Soyeon Yoo ◽

Gwanpyo Koh

Keyword(s):

Type 2 Diabetes ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function

Download Full-text

Effects of efpeglenatide versus liraglutide on gastric emptying, glucose metabolism and beta-cell function in people with type 2 diabetes: an exploratory, randomized phase Ib study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2021-002208 ◽

2021 ◽

Vol 9 (1) ◽

pp. e002208

Author(s):

Marcus Hompesch ◽

Jahoon Kang ◽

OakPil Han ◽

Michael E Trautmann ◽

Christopher H Sorli ◽

...

Keyword(s):

Type 2 Diabetes ◽

Gastric Emptying ◽

Glucose Metabolism ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Phase Ib ◽

Link Type ◽

Drug Concentrations

IntroductionTo evaluate the effects of efpeglenatide, a long-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA), on gastric emptying, glucose metabolism, and islet beta-cell function versus liraglutide and placebo in people with type 2 diabetes.Research design and methodsThis phase Ib study (ClinicalTrials.gov identifier: NCT02059564) randomized participants (n=47) to three cohorts. Within the first two cohorts, participants were randomized to placebo, efpeglenatide 6 mg weekly (QW; first cohort), or efpeglenatide 16 mg monthly (QM; second cohort). The third cohort received liraglutide 1.8 mg daily (QD). Gastric emptying was assessed through the pharmacokinetic (PK) profile of acetaminophen at baseline and steady state. Glucose metabolism and beta-cell function were assessed based on mixed-meal tolerance testing and a graded glucose infusion procedure.ResultsTreatment duration was approximately 3 months for efpeglenatide 16 mg QM and 1 month for efpeglenatide 6 mg QW and liraglutide. At peak drug concentrations, efpeglenatide 6 mg QW was non-inferior to liraglutide 1.8 mg QD in delaying gastric emptying, as assessed by acetaminophen PK (lower bound of 90% CI for the efpeglenatide:liraglutide ratio >0.8 for area under the curve (AUC)0–120, AUC0–180, AUC0–360 and maximum concentration (Cmax)). Efpeglenatide 16 mg QM did not decrease the rate of gastric emptying to as great an extent as liraglutide (ie, non-inferiority was not shown). Compared with liraglutide, both efpeglenatide dosing regimens demonstrated comparable or more favorable glucometabolic effects and improved beta-cell function. All gastrointestinal adverse events reported with efpeglenatide were mild or moderate in severity and transient over treatment and follow-up.ConclusionsThe glucometabolic effects of efpeglenatide 6 mg QW and 16 mg QM were comparable to liraglutide. Additional studies are necessary to further examine these benefits of efpeglenatide.Trial registration numberNCT02059564.

Download Full-text