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Diabetes Obes Metab. 2018 Apr;20(4):872-878. doi: 10.1111/dom.13165. Epub 2017 Dec 18.

Beta-cell sensitivity to glucose is impaired after gastric bypass surgery.

Author information

1
Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
2
Cardiometabolic Risk Unit, CNR Institute of Clinical Physiology, Pisa, Italy.

Abstract

AIMS:

Patients who have undergone Roux-en-Y gastric bypass surgery (GB) have exaggerated postprandial insulin secretion, which has been attributed to increased meal glucose appearance and enhanced incretin effect. Here, we sought to determine β-cell glucose sensitivity in the absence of meal stimulation and insulinotropic gut factors.

MATERIALS AND METHODS:

A total of 12 non-diabetic subjects with prior GB, and 7 matched non-surgical control subjects with normal glucose tolerance were studied. Blood glucose and insulin secretion rates were measured during a graded glucose infusion at increasing and then decreasing rates. Insulin sensitivity (SI ) and glucose effectiveness (SG ) were determined by the minimal model.

RESULTS:

GB subjects had SI comparable to that of control subjects. GB subjects had relative hyperglycaemia during the highest dose of glucose infusion associated with significantly reduced β-cell glucose sensitivity throughout both step-up (GB: 34 ± 6, CN: 82 ± 9 pmol min-1 mM-1 L, P < .0001) and step-down (GB: 31 ± 6, CN: 74 ± 9 pmol min-1 mM-1 L, P < .0001) phases of the glucose infusion. GB subjects also had reduced SG (GB: 0.04 ± 0.00, CN: 0.07 ± 0.01 min-1 , P = .004).

CONCLUSION:

In the absence of enteric stimuli, β-cell sensitivity to changes in glycaemia is blunted among individuals with GB, indicating a significant shift in a fundamental property of β-cell function several years after surgery.

KEYWORDS:

gastric bypass surgery; glucose tolerance; β-cell glucose sensitivity

PMID:
29152839
PMCID:
PMC5847451
DOI:
10.1111/dom.13165
[Indexed for MEDLINE]
Free PMC Article

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