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Diabetes Care. 2010 Feb;33(2):375-7. doi: 10.2337/dc09-1374. Epub 2009 Nov 16.

Postprandial diabetic glucose tolerance is normalized by gastric bypass feeding as opposed to gastric feeding and is associated with exaggerated GLP-1 secretion: a case report.

Author information

1
Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark. cardir@gmail.com

Abstract

OBJECTIVE:

To examine after gastric bypass the effect of peroral versus gastroduodenal feeding on glucose metabolism.

RESEARCH DESIGN AND METHODS:

A type 2 diabetic patient was examined on 2 consecutive days 5 weeks after gastric bypass. A standard liquid meal was given on the first day into the bypassed gastric remnant and on the second day perorally. Plasma glucose, insulin, C-peptide, glucagon, incretin hormones, peptide YY, and free fatty acids were measured.

RESULTS:

Peroral feeding reduced 2-h postprandial plasma glucose (7.8 vs. 11.1 mmol/l) and incremental area under the glucose curve (iAUC) (0.33 vs. 0.49 mmol . l(-1) . min(-1)) compared with gastroduodenal feeding. beta-Cell function (iAUC(Cpeptide/Glu)) was more than twofold improved during peroral feeding, and the glucagon-like peptide (GLP)-1 response increased nearly fivefold.

CONCLUSIONS:

Improvement in postprandial glucose metabolism after gastric bypass is an immediate and direct consequence of the gastrointestinal rearrangement, associated with exaggerated GLP-1 release and independent of changes in insulin sensitivity, weight loss, and caloric restriction.

PMID:
19918005
PMCID:
PMC2809286
DOI:
10.2337/dc09-1374
[Indexed for MEDLINE]
Free PMC Article

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