Insulin sensitivity and secretion in obese Type 2 diabetic women after various bariatric operations

Jana Vrbikova*, Marie Kunesova, Ioannis Kyrou, Andrea Tura, Martin Hill, Tereza Grimmichova, Katerina Dvorakova, Petra Sramkova, Karin Dolezalova, Olga Lischkova, Josef Vcelak, Vojtech Hainer, Bela Bendlova, Sudhesh Kumar, Martin Fried

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: To compare the effects of biliopancreatic diversion (BPD) and laparoscopic gastric banding (LAGB) on insulin sensitivity and secretion with the effects of laparoscopic gastric plication (P).
Methods: A total of 52 obese women (age 30-66 years) suffering from type 2 diabetes mellitus (T2DM) were prospectively recruited into three study groups: 16 BPD; 16 LAGB, and 20 P. Euglycemic clamps and mixed meal tolerance tests were performed before, at 1 month and at 6 months after bariatric surgery. Beta cell function derived from the meal test parameters was evaluated using mathematical modeling.
Results: Glucose disposal per kilogram of fat free mass (a marker of peripheral insulin sensitivity) increased significantly in all groups, especially after 1 month. Basal insulin secretion decreased significantly after all three types of operations, with the most marked decrease after BPD compared with P and LAGB. Total insulin secretion decreased significantly only following the BPD. Beta cell glucose sensitivity did not change significantly post-surgery in any of the study groups.
Conclusion: We documented similar improvement in insulin sensitivity in obese T2DM women after all three study operations during the 6-month postoperative follow-up. Notably, only BPD led to decreased demand on beta cells (decreased integrated insulin secretion), but without increasing the beta cell glucose sensitivity.
Original languageEnglish
Pages (from-to)410-423
Number of pages14
JournalObesity Facts
Volume9
Issue number6
Early online date13 Dec 2016
DOIs
Publication statusPublished - Dec 2016

Bibliographical note

This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.

Keywords

  • insulin sensitivity
  • beta cell function
  • biliopancreatic diversion
  • laparoscopic gastric banding
  • laparoscopic gastric plication

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    Vrbikova, J., Kunesova, M., Kyrou, I., Tura, A., Hill, M., Grimmichova, T., Dvorakova, K., Sramkova, P., Dolezalova, K., Lischkova, O., Vcelak, J., Hainer, V., Bendlova, B., Kumar, S., & Fried, M. (2016). Insulin sensitivity and secretion in obese Type 2 diabetic women after various bariatric operations. Obesity Facts, 9(6), 410-423. https://doi.org/10.1159/000453000