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. β-Cell function (iAUCCpeptide/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.
| Original language | English |
|---|---|
| Journal | Diabetes Care |
| Volume | 33 |
| Issue number | 2 |
| Pages (from-to) | 375-7 |
| Number of pages | 3 |
| DOIs | |
| Publication status | Published - Feb 2010 |
Keywords
- Area Under Curve
- Blood Glucose
- C-Peptide
- Diabetes Mellitus, Type 2
- Enteral Nutrition
- Fatty Acids, Nonesterified
- Gastric Bypass
- Glucagon
- Glucagon-Like Peptide 1
- Humans
- Incretins
- Male
- Middle Aged
- Obesity, Morbid
- Peptide YY
- Postoperative Period
- Postprandial Period
