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April 23, 2008The Journal of Clinical Endocrinology & MetabolismOpen Access

Effect of Weight Loss by Gastric Bypass Surgery Versus Hypocaloric Diet on Glucose and Incretin Levels in Patients with Type 2 Diabetes

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Authors

BLBlandine LaferrèreNew York State Department of StateJTJúlio TeixeiraPhelps HospitalJMJames McGintyImperial College London

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Implication

Comparative study reveals superior incretin effect and glucose reductions following gastric bypass versus diet in women with type 2 diabetes, indicating surgery-specific metabolic benefits beyond...

Key Points

  • To determine whether gastric bypass surgery induces greater improvements in incretin levels and action compared to an equivalent degree of weight loss achieved via a hypocaloric diet in patients with type 2 diabetes.
  • Conducted a matched outpatient study comparing obese women with type 2 diabetes evaluated before and 1 month after gastric bypass surgery (n = 9) or equivalent diet-induced weight loss (n = 10).
  • Matched both cohorts for age, body weight, body mass index, diabetes duration, glycemic control, and magnitude of weight reduction.
  • Measured plasma glucose, insulin, proinsulin, glucagon, GIP, and GLP-1 after a 50-g oral glucose tolerance test and quantified the incretin effect using an isoglycemic intravenous glucose infusion.
  • Total peak GLP-1 levels increased sixfold following gastric bypass (17 ± 6 to 112 ± 54 pmol/L; P < 0.001) but remained unchanged after dietary weight loss.
  • The incretin effect increased fivefold after gastric bypass surgery (from 9.4 ± 27.5% to 44.8 ± 12.7%; P < 0.001), whereas no significant change occurred after hypocaloric diet.
  • Postprandial glucose concentrations decreased significantly more after gastric bypass surgery than after equivalent diet-induced weight loss (P = 0.001).

Cite This Study

Laferrère et al. (2008) studied this question.

synapsesocial.com/papers/6a14e405253bd9cd3ce62819https://doi.org/10.1210/jc.2007-2851
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