Affiliation:
1. Division of Diabetes, Department of Medicine University of Texas Health at San Antonio San Antonio Texas USA
2. South Texas Veteran Health Care System, Audie Murphy Hospital San Antonio Texas USA
3. Department of Surgery University of Texas Health at San Antonio San Antonio Texas USA
4. Cardiometabolic Risk Unit CNR Institute of Clinical Physiology Pisa Italy
Abstract
AbstractObjectivePrandial hyperinsulinemia after Roux‐en‐Y gastric bypass surgery (GB), and to lesser degree after sleeve gastrectomy (SG), has been attributed to rapid glucose flux from the gut and increased insulinotropic gut hormones. However, β‐cell sensitivity to exogenous incretin is reduced after GB. This study examines the effect of GB versus SG on prandial glycemia and β‐cell response to increasing concentrations of endogenous incretins.MethodsGlucose kinetics, insulin secretion rate (ISR), and incretin responses to 50‐g oral glucose ingestion were compared between ten nondiabetic participants with GB versus nine matched individuals with SG and seven nonoperated normal glucose tolerant control individuals (CN) with and without administration of 200 mg of sitagliptin.ResultsFasting glucose and hormonal levels were similar among three groups. Increasing plasma concentrations of endogenous incretins by two‐ to three‐fold diminished prandial glycemia and increased β‐cell secretion in all three groups (p < 0.05), but insulin secretion per insulin sensitivity (i.e., disposition index) was increased only in GB (p < 0.05 for interaction). However, plot of the slope of ISR (from premeal to peak values) versus plasma glucagon‐like peptide‐1 concentration was smaller after GB compared with SG and CN.ConclusionsAfter GB, increasing incretin activity augments prandial β‐cell response whereas the β‐cell sensitivity to increasing plasma concentrations of endogenous incretin is diminished.image
Subject
Nutrition and Dietetics,Endocrinology,Endocrinology, Diabetes and Metabolism,Medicine (miscellaneous)
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献