Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass

C Dirksen; N B Jørgensen; K N Bojsen-Møller; S H Jacobsen; D L Hansen; D Worm; Jens Juul Holst; S Madsbad

doi:10.1007/s00125-012-2556-7

Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass

C Dirksen, N B Jørgensen, K N Bojsen-Møller, S H Jacobsen, D L Hansen, D Worm, Jens Juul Holst, S Madsbad

162 Citations (Scopus)

Abstract

Roux-en-Y gastric bypass (RYGB) greatly improves glycaemic control in morbidly obese patients with type 2 diabetes, in many even before significant weight loss. Understanding the responsible mechanisms may contribute to our knowledge of the pathophysiology of type 2 diabetes and help identify new drug targets or improve surgical techniques. This review summarises the present knowledge based on pathophysiological studies published during the last decade. Taken together, two main mechanisms seem to be responsible for the early improvement in glycaemic control after RYGB: (1) an increase in hepatic insulin sensitivity induced, at least in part, by energy restriction and (2) improved beta cell function associated with an exaggerated postprandial glucagon-like peptide 1 secretion owing to the altered transit of nutrients. Later a weight loss induced improvement in peripheral insulin sensitivity follows.

Original language	English
Journal	Diabetologia
Volume	55
Issue number	7
Pages (from-to)	1890-901
Number of pages	12
ISSN	0012-186X
DOIs	https://doi.org/10.1007/s00125-012-2556-7
Publication status	Published - Jul 2012

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title = "Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass",

abstract = "Roux-en-Y gastric bypass (RYGB) greatly improves glycaemic control in morbidly obese patients with type 2 diabetes, in many even before significant weight loss. Understanding the responsible mechanisms may contribute to our knowledge of the pathophysiology of type 2 diabetes and help identify new drug targets or improve surgical techniques. This review summarises the present knowledge based on pathophysiological studies published during the last decade. Taken together, two main mechanisms seem to be responsible for the early improvement in glycaemic control after RYGB: (1) an increase in hepatic insulin sensitivity induced, at least in part, by energy restriction and (2) improved beta cell function associated with an exaggerated postprandial glucagon-like peptide 1 secretion owing to the altered transit of nutrients. Later a weight loss induced improvement in peripheral insulin sensitivity follows.",

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T1 - Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass

AU - Dirksen, C

AU - Jørgensen, N B

AU - Bojsen-Møller, K N

AU - Jacobsen, S H

AU - Hansen, D L

AU - Worm, D

AU - Holst, Jens Juul

AU - Madsbad, S

PY - 2012/7

Y1 - 2012/7

N2 - Roux-en-Y gastric bypass (RYGB) greatly improves glycaemic control in morbidly obese patients with type 2 diabetes, in many even before significant weight loss. Understanding the responsible mechanisms may contribute to our knowledge of the pathophysiology of type 2 diabetes and help identify new drug targets or improve surgical techniques. This review summarises the present knowledge based on pathophysiological studies published during the last decade. Taken together, two main mechanisms seem to be responsible for the early improvement in glycaemic control after RYGB: (1) an increase in hepatic insulin sensitivity induced, at least in part, by energy restriction and (2) improved beta cell function associated with an exaggerated postprandial glucagon-like peptide 1 secretion owing to the altered transit of nutrients. Later a weight loss induced improvement in peripheral insulin sensitivity follows.

AB - Roux-en-Y gastric bypass (RYGB) greatly improves glycaemic control in morbidly obese patients with type 2 diabetes, in many even before significant weight loss. Understanding the responsible mechanisms may contribute to our knowledge of the pathophysiology of type 2 diabetes and help identify new drug targets or improve surgical techniques. This review summarises the present knowledge based on pathophysiological studies published during the last decade. Taken together, two main mechanisms seem to be responsible for the early improvement in glycaemic control after RYGB: (1) an increase in hepatic insulin sensitivity induced, at least in part, by energy restriction and (2) improved beta cell function associated with an exaggerated postprandial glucagon-like peptide 1 secretion owing to the altered transit of nutrients. Later a weight loss induced improvement in peripheral insulin sensitivity follows.

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DO - 10.1007/s00125-012-2556-7

M3 - Journal article

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EP - 1901

JO - Diabetologia

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Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass

Abstract

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