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

doi:10.1159/000453000

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

Aston Medical School

Institute of Endocrinology, Prague
Obesity Management Centre, Prague
Univerzita Karlova
OB Klinika, Prague
University of Warwick
University Hospitals of Coventry and Warwickshire NHS Trust
ISIB CNR, Padova

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

74 Downloads (Pure)

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 language	English
Pages (from-to)	410-423
Number of pages	14
Journal	Obesity Facts
Volume	9
Issue number	6
Early online date	13 Dec 2016
DOIs	https://doi.org/10.1159/000453000
Publication status	Published - 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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10.1159/000453000Licence: CC BY-NC-ND 3.0

Obese type 2 diabetic women after bariatric operations
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.
Final published version, 928 KBLicence: CC BY-NC-ND 3.0

Cite this

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title = "Insulin sensitivity and secretion in obese Type 2 diabetic women after various bariatric operations",

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.",

keywords = "insulin sensitivity, beta cell function, biliopancreatic diversion, laparoscopic gastric banding, laparoscopic gastric plication",

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

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.",

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doi = "10.1159/000453000",

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T1 - Insulin sensitivity and secretion in obese Type 2 diabetic women after various bariatric operations

AU - Vrbikova, Jana

AU - Kunesova, Marie

AU - Kyrou, Ioannis

AU - Tura, Andrea

AU - Hill, Martin

AU - Grimmichova, Tereza

AU - Dvorakova, Katerina

AU - Sramkova, Petra

AU - Dolezalova, Karin

AU - Lischkova, Olga

AU - Vcelak, Josef

AU - Hainer, Vojtech

AU - Bendlova, Bela

AU - Kumar, Sudhesh

AU - Fried, Martin

N1 - 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.

PY - 2016/12

Y1 - 2016/12

N2 - 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.

AB - 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.

KW - insulin sensitivity

KW - beta cell function

KW - biliopancreatic diversion

KW - laparoscopic gastric banding

KW - laparoscopic gastric plication

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DO - 10.1159/000453000

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SN - 1662-4025

VL - 9

SP - 410

EP - 423

JO - Obesity Facts

JF - Obesity Facts

IS - 6

ER -

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

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