Insulin sensitivity and secretion in obese Type 2 diabetic women after various bariatric operations

Vrbikova, Jana, Kunesova, Marie, Kyrou, Ioannis, Tura, Andrea, Hill, Martin, Grimmichova, Tereza, Dvorakova, Katerina, Sramkova, Petra, Dolezalova, Karin, Lischkova, Olga, Vcelak, Josef, Hainer, Vojtech, Bendlova, Bela, Kumar, Sudhesh and Fried, Martin (2016). Insulin sensitivity and secretion in obese Type 2 diabetic women after various bariatric operations. Obesity Facts, 9 (6), pp. 410-423.


Objective: To compare the effects of biliopancreatic diversion (BPD) and laparoscopic gastric banding (LAGB) on insulin sensitivity and secretion with the effects of laparoscopic gastric plication (P). Methods: A total of 52 obese women (age 30-66 years) suffering from type 2 diabetes mellitus (T2DM) were prospectively recruited into three study groups: 16 BPD; 16 LAGB, and 20 P. Euglycemic clamps and mixed meal tolerance tests were performed before, at 1 month and at 6 months after bariatric surgery. Beta cell function derived from the meal test parameters was evaluated using mathematical modeling. Results: Glucose disposal per kilogram of fat free mass (a marker of peripheral insulin sensitivity) increased significantly in all groups, especially after 1 month. Basal insulin secretion decreased significantly after all three types of operations, with the most marked decrease after BPD compared with P and LAGB. Total insulin secretion decreased significantly only following the BPD. Beta cell glucose sensitivity did not change significantly post-surgery in any of the study groups. Conclusion: We documented similar improvement in insulin sensitivity in obese T2DM women after all three study operations during the 6-month postoperative follow-up. Notably, only BPD led to decreased demand on beta cells (decreased integrated insulin secretion), but without increasing the beta cell glucose sensitivity.

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Divisions: Aston Medical School
Additional Information: This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) ( Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.
Uncontrolled Keywords: insulin sensitivity,beta cell function,biliopancreatic diversion,laparoscopic gastric banding,laparoscopic gastric plication,Health(social science),Physiology (medical)
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Published Date: 2016-12
Authors: Vrbikova, Jana
Kunesova, Marie
Kyrou, Ioannis ( 0000-0002-6997-3439)
Tura, Andrea
Hill, Martin
Grimmichova, Tereza
Dvorakova, Katerina
Sramkova, Petra
Dolezalova, Karin
Lischkova, Olga
Vcelak, Josef
Hainer, Vojtech
Bendlova, Bela
Kumar, Sudhesh
Fried, Martin

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