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

Abstract

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.

Publication DOI: https://doi.org/10.1159/000453000
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) (http://www.karger.com/Services/OpenAccessLicense). 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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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2016-12
Published Online Date: 2016-12-13
Accepted Date: 2016-10-27
Submitted Date: 2016-04-14
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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