Hepatic and Peripheral Insulin Sensitivity and Diabetes Remission at 1 Month After Roux-en-Y Gastric Bypass Surgery in Patients Randomized to Omentectomy
Early after Roux-en-Y gastric bypass (RYGB), there is improvement in type 2 diabetes, which is characterized by insulin resistance. We determined the acute effects of RYGB, with and without omentectomy, on hepatic and peripheral insulin sensitivity. We also investigated whether preoperative diabetes...
Gespeichert in:
| Veröffentlicht in: | Diabetes care 2012-01, Vol.35 (1), p.137-142 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 142 |
|---|---|
| container_issue | 1 |
| container_start_page | 137 |
| container_title | Diabetes care |
| container_volume | 35 |
| creator | DUNN, Julia P ABUMRAD, Naji N BREITMAN, Igal MARKS-SHULMAN, Pamela A ROBB FLYNN, Charles JABBOUR, Kareem FEURER, Irene D TAMBOLI, Robyn A |
| description | Early after Roux-en-Y gastric bypass (RYGB), there is improvement in type 2 diabetes, which is characterized by insulin resistance. We determined the acute effects of RYGB, with and without omentectomy, on hepatic and peripheral insulin sensitivity. We also investigated whether preoperative diabetes or postoperative diabetes remission influenced tissue-specific insulin sensitivity after RYGB.
We studied 40 obese (BMI 48 ± 8 kg/m(2)) participants, 17 with diabetes. Participants were randomized to RYGB alone or in conjunction with omentectomy. Hyperinsulinemic-euglycemic clamps with isotopic-tracer infusion were completed at baseline and at 1 month postoperatively to assess insulin sensitivity.
Participants lost 11 ± 4% of body weight at 1 month after RYGB, without an improvement in peripheral insulin sensitivity; these outcomes were not affected by omentectomy, preoperative diabetes, or remission of diabetes. Hepatic glucose production (HGP) and the hepatic insulin sensitivity index improved in all subjects, irrespective of omentectomy (P ≤ 0.001). Participants with diabetes had higher baseline HGP values (P = 0.003) that improved to a greater extent after RYGB (P = 0.006). Of the 17 participants with diabetes, 10 (59%) had remission at 1 month. Diabetes remission had a group × time effect (P = 0.041) on HGP; those with diabetes remission had lower preoperative and postoperative HGP.
Peripheral insulin sensitivity did not improve 1 month after RYGB, irrespective of omentectomy, diabetes, or diabetes remission. Hepatic insulin sensitivity improved at 1 month after RYGB and was more pronounced in patients with diabetes. Improvement in HGP may influence diabetes remission early after RYGB. |
| doi_str_mv | 10.2337/dc11-1383 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3241322</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A280004168</galeid><sourcerecordid>A280004168</sourcerecordid><originalsourceid>FETCH-LOGICAL-c536t-df32f21c2e384fd70e9f6da1e911c4a11db22ad61f2fb92cd935efcdcfbee7953</originalsourceid><addsrcrecordid>eNptks1uEzEUhUcIREthwQsgC4QQiynjn_nxBikUaCsVtWphwcpy7OvE1YwdbE9FeBPeFg8JhaLIC0v2d8-1zz1F8RRXh4TS9o1WGJeYdvResY85rcu6Zt39Yr_CjJc152SveBTjdVVVjHXdw2KPkIpVHcP7xc8TWMlkFZJOowsIdrWEIHt06uLYW4euwEWb7I1N69_IeyvnkCCiSxhsjNY7JBPC6JN3aYlmJkFAl378XoIrv6JjGVPI4u_WKxkjuhrDAsIaZd2L3BRcyjpZ1Q_2B2iUPDof8iGo5If14-KBkX2EJ9v9oPjy8cPno5Py7Pz49Gh2VqqaNqnUhhJDsCJAO2Z0WwE3jZYYOMaKSYz1nBCpG2yImXOidPYHjNLKzAFaXtOD4u1GdzXOB9AqPyAbIFbBDjKshZdW3L1xdikW_kZQwjAlJAu82goE_22EmER2RkHfSwd-jIJjwkjT0ol8_h957cfg8u8yxDirW84z9GIDLWQPwjrjc1c1SYoZ6aYZ4qbLVLmDWoCbpucdGJuP7_CHO_i8dJ6j2lnwelOggo8xgLl1BFdiSp2YUiem1GX22b8W3pJ_YpaBl1tARiV7E6RTNv7l6rapmpbQX68o4MQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>914945799</pqid></control><display><type>article</type><title>Hepatic and Peripheral Insulin Sensitivity and Diabetes Remission at 1 Month After Roux-en-Y Gastric Bypass Surgery in Patients Randomized to Omentectomy</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>DUNN, Julia P ; ABUMRAD, Naji N ; BREITMAN, Igal ; MARKS-SHULMAN, Pamela A ; ROBB FLYNN, Charles ; JABBOUR, Kareem ; FEURER, Irene D ; TAMBOLI, Robyn A</creator><creatorcontrib>DUNN, Julia P ; ABUMRAD, Naji N ; BREITMAN, Igal ; MARKS-SHULMAN, Pamela A ; ROBB FLYNN, Charles ; JABBOUR, Kareem ; FEURER, Irene D ; TAMBOLI, Robyn A</creatorcontrib><description>Early after Roux-en-Y gastric bypass (RYGB), there is improvement in type 2 diabetes, which is characterized by insulin resistance. We determined the acute effects of RYGB, with and without omentectomy, on hepatic and peripheral insulin sensitivity. We also investigated whether preoperative diabetes or postoperative diabetes remission influenced tissue-specific insulin sensitivity after RYGB.
We studied 40 obese (BMI 48 ± 8 kg/m(2)) participants, 17 with diabetes. Participants were randomized to RYGB alone or in conjunction with omentectomy. Hyperinsulinemic-euglycemic clamps with isotopic-tracer infusion were completed at baseline and at 1 month postoperatively to assess insulin sensitivity.
Participants lost 11 ± 4% of body weight at 1 month after RYGB, without an improvement in peripheral insulin sensitivity; these outcomes were not affected by omentectomy, preoperative diabetes, or remission of diabetes. Hepatic glucose production (HGP) and the hepatic insulin sensitivity index improved in all subjects, irrespective of omentectomy (P ≤ 0.001). Participants with diabetes had higher baseline HGP values (P = 0.003) that improved to a greater extent after RYGB (P = 0.006). Of the 17 participants with diabetes, 10 (59%) had remission at 1 month. Diabetes remission had a group × time effect (P = 0.041) on HGP; those with diabetes remission had lower preoperative and postoperative HGP.
Peripheral insulin sensitivity did not improve 1 month after RYGB, irrespective of omentectomy, diabetes, or diabetes remission. Hepatic insulin sensitivity improved at 1 month after RYGB and was more pronounced in patients with diabetes. Improvement in HGP may influence diabetes remission early after RYGB.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc11-1383</identifier><identifier>PMID: 22040841</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Adult ; Biological and medical sciences ; Blood Glucose - metabolism ; Diabetes ; Diabetes Mellitus, Type 2 - surgery ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Gastric Bypass ; Gastrointestinal surgery ; Glucose Clamp Technique ; Humans ; Insulin ; Insulin Resistance ; Liver - metabolism ; Male ; Medical sciences ; Metabolic diseases ; Middle Aged ; Miscellaneous ; Obesity - surgery ; Omentum - surgery ; Original Research ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Remission Induction ; Treatment Outcome ; Type 2 diabetes ; Weight control ; Weight Loss</subject><ispartof>Diabetes care, 2012-01, Vol.35 (1), p.137-142</ispartof><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2012 American Diabetes Association</rights><rights>Copyright American Diabetes Association Jan 2012</rights><rights>2012 by the American Diabetes Association. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-df32f21c2e384fd70e9f6da1e911c4a11db22ad61f2fb92cd935efcdcfbee7953</citedby><cites>FETCH-LOGICAL-c536t-df32f21c2e384fd70e9f6da1e911c4a11db22ad61f2fb92cd935efcdcfbee7953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25760672$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22040841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DUNN, Julia P</creatorcontrib><creatorcontrib>ABUMRAD, Naji N</creatorcontrib><creatorcontrib>BREITMAN, Igal</creatorcontrib><creatorcontrib>MARKS-SHULMAN, Pamela A</creatorcontrib><creatorcontrib>ROBB FLYNN, Charles</creatorcontrib><creatorcontrib>JABBOUR, Kareem</creatorcontrib><creatorcontrib>FEURER, Irene D</creatorcontrib><creatorcontrib>TAMBOLI, Robyn A</creatorcontrib><title>Hepatic and Peripheral Insulin Sensitivity and Diabetes Remission at 1 Month After Roux-en-Y Gastric Bypass Surgery in Patients Randomized to Omentectomy</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>Early after Roux-en-Y gastric bypass (RYGB), there is improvement in type 2 diabetes, which is characterized by insulin resistance. We determined the acute effects of RYGB, with and without omentectomy, on hepatic and peripheral insulin sensitivity. We also investigated whether preoperative diabetes or postoperative diabetes remission influenced tissue-specific insulin sensitivity after RYGB.
We studied 40 obese (BMI 48 ± 8 kg/m(2)) participants, 17 with diabetes. Participants were randomized to RYGB alone or in conjunction with omentectomy. Hyperinsulinemic-euglycemic clamps with isotopic-tracer infusion were completed at baseline and at 1 month postoperatively to assess insulin sensitivity.
Participants lost 11 ± 4% of body weight at 1 month after RYGB, without an improvement in peripheral insulin sensitivity; these outcomes were not affected by omentectomy, preoperative diabetes, or remission of diabetes. Hepatic glucose production (HGP) and the hepatic insulin sensitivity index improved in all subjects, irrespective of omentectomy (P ≤ 0.001). Participants with diabetes had higher baseline HGP values (P = 0.003) that improved to a greater extent after RYGB (P = 0.006). Of the 17 participants with diabetes, 10 (59%) had remission at 1 month. Diabetes remission had a group × time effect (P = 0.041) on HGP; those with diabetes remission had lower preoperative and postoperative HGP.
Peripheral insulin sensitivity did not improve 1 month after RYGB, irrespective of omentectomy, diabetes, or diabetes remission. Hepatic insulin sensitivity improved at 1 month after RYGB and was more pronounced in patients with diabetes. Improvement in HGP may influence diabetes remission early after RYGB.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - metabolism</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - surgery</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Gastric Bypass</subject><subject>Gastrointestinal surgery</subject><subject>Glucose Clamp Technique</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin Resistance</subject><subject>Liver - metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Obesity - surgery</subject><subject>Omentum - surgery</subject><subject>Original Research</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Remission Induction</subject><subject>Treatment Outcome</subject><subject>Type 2 diabetes</subject><subject>Weight control</subject><subject>Weight Loss</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptks1uEzEUhUcIREthwQsgC4QQiynjn_nxBikUaCsVtWphwcpy7OvE1YwdbE9FeBPeFg8JhaLIC0v2d8-1zz1F8RRXh4TS9o1WGJeYdvResY85rcu6Zt39Yr_CjJc152SveBTjdVVVjHXdw2KPkIpVHcP7xc8TWMlkFZJOowsIdrWEIHt06uLYW4euwEWb7I1N69_IeyvnkCCiSxhsjNY7JBPC6JN3aYlmJkFAl378XoIrv6JjGVPI4u_WKxkjuhrDAsIaZd2L3BRcyjpZ1Q_2B2iUPDof8iGo5If14-KBkX2EJ9v9oPjy8cPno5Py7Pz49Gh2VqqaNqnUhhJDsCJAO2Z0WwE3jZYYOMaKSYz1nBCpG2yImXOidPYHjNLKzAFaXtOD4u1GdzXOB9AqPyAbIFbBDjKshZdW3L1xdikW_kZQwjAlJAu82goE_22EmER2RkHfSwd-jIJjwkjT0ol8_h957cfg8u8yxDirW84z9GIDLWQPwjrjc1c1SYoZ6aYZ4qbLVLmDWoCbpucdGJuP7_CHO_i8dJ6j2lnwelOggo8xgLl1BFdiSp2YUiem1GX22b8W3pJ_YpaBl1tARiV7E6RTNv7l6rapmpbQX68o4MQ</recordid><startdate>20120101</startdate><enddate>20120101</enddate><creator>DUNN, Julia P</creator><creator>ABUMRAD, Naji N</creator><creator>BREITMAN, Igal</creator><creator>MARKS-SHULMAN, Pamela A</creator><creator>ROBB FLYNN, Charles</creator><creator>JABBOUR, Kareem</creator><creator>FEURER, Irene D</creator><creator>TAMBOLI, Robyn A</creator><general>American Diabetes Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120101</creationdate><title>Hepatic and Peripheral Insulin Sensitivity and Diabetes Remission at 1 Month After Roux-en-Y Gastric Bypass Surgery in Patients Randomized to Omentectomy</title><author>DUNN, Julia P ; ABUMRAD, Naji N ; BREITMAN, Igal ; MARKS-SHULMAN, Pamela A ; ROBB FLYNN, Charles ; JABBOUR, Kareem ; FEURER, Irene D ; TAMBOLI, Robyn A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-df32f21c2e384fd70e9f6da1e911c4a11db22ad61f2fb92cd935efcdcfbee7953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - metabolism</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - surgery</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Gastric Bypass</topic><topic>Gastrointestinal surgery</topic><topic>Glucose Clamp Technique</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin Resistance</topic><topic>Liver - metabolism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Obesity - surgery</topic><topic>Omentum - surgery</topic><topic>Original Research</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Remission Induction</topic><topic>Treatment Outcome</topic><topic>Type 2 diabetes</topic><topic>Weight control</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DUNN, Julia P</creatorcontrib><creatorcontrib>ABUMRAD, Naji N</creatorcontrib><creatorcontrib>BREITMAN, Igal</creatorcontrib><creatorcontrib>MARKS-SHULMAN, Pamela A</creatorcontrib><creatorcontrib>ROBB FLYNN, Charles</creatorcontrib><creatorcontrib>JABBOUR, Kareem</creatorcontrib><creatorcontrib>FEURER, Irene D</creatorcontrib><creatorcontrib>TAMBOLI, Robyn A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Agricultural Science Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DUNN, Julia P</au><au>ABUMRAD, Naji N</au><au>BREITMAN, Igal</au><au>MARKS-SHULMAN, Pamela A</au><au>ROBB FLYNN, Charles</au><au>JABBOUR, Kareem</au><au>FEURER, Irene D</au><au>TAMBOLI, Robyn A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatic and Peripheral Insulin Sensitivity and Diabetes Remission at 1 Month After Roux-en-Y Gastric Bypass Surgery in Patients Randomized to Omentectomy</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2012-01-01</date><risdate>2012</risdate><volume>35</volume><issue>1</issue><spage>137</spage><epage>142</epage><pages>137-142</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>Early after Roux-en-Y gastric bypass (RYGB), there is improvement in type 2 diabetes, which is characterized by insulin resistance. We determined the acute effects of RYGB, with and without omentectomy, on hepatic and peripheral insulin sensitivity. We also investigated whether preoperative diabetes or postoperative diabetes remission influenced tissue-specific insulin sensitivity after RYGB.
We studied 40 obese (BMI 48 ± 8 kg/m(2)) participants, 17 with diabetes. Participants were randomized to RYGB alone or in conjunction with omentectomy. Hyperinsulinemic-euglycemic clamps with isotopic-tracer infusion were completed at baseline and at 1 month postoperatively to assess insulin sensitivity.
Participants lost 11 ± 4% of body weight at 1 month after RYGB, without an improvement in peripheral insulin sensitivity; these outcomes were not affected by omentectomy, preoperative diabetes, or remission of diabetes. Hepatic glucose production (HGP) and the hepatic insulin sensitivity index improved in all subjects, irrespective of omentectomy (P ≤ 0.001). Participants with diabetes had higher baseline HGP values (P = 0.003) that improved to a greater extent after RYGB (P = 0.006). Of the 17 participants with diabetes, 10 (59%) had remission at 1 month. Diabetes remission had a group × time effect (P = 0.041) on HGP; those with diabetes remission had lower preoperative and postoperative HGP.
Peripheral insulin sensitivity did not improve 1 month after RYGB, irrespective of omentectomy, diabetes, or diabetes remission. Hepatic insulin sensitivity improved at 1 month after RYGB and was more pronounced in patients with diabetes. Improvement in HGP may influence diabetes remission early after RYGB.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>22040841</pmid><doi>10.2337/dc11-1383</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2012-01, Vol.35 (1), p.137-142 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3241322 |
| source | MEDLINE; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Biological and medical sciences Blood Glucose - metabolism Diabetes Diabetes Mellitus, Type 2 - surgery Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Gastric Bypass Gastrointestinal surgery Glucose Clamp Technique Humans Insulin Insulin Resistance Liver - metabolism Male Medical sciences Metabolic diseases Middle Aged Miscellaneous Obesity - surgery Omentum - surgery Original Research Public health. Hygiene Public health. Hygiene-occupational medicine Remission Induction Treatment Outcome Type 2 diabetes Weight control Weight Loss |
| title | Hepatic and Peripheral Insulin Sensitivity and Diabetes Remission at 1 Month After Roux-en-Y Gastric Bypass Surgery in Patients Randomized to Omentectomy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-10T05%3A24%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hepatic%20and%20Peripheral%20Insulin%20Sensitivity%20and%20Diabetes%20Remission%20at%201%20Month%20After%20Roux-en-Y%20Gastric%20Bypass%20Surgery%20in%20Patients%20Randomized%20to%20Omentectomy&rft.jtitle=Diabetes%20care&rft.au=DUNN,%20Julia%20P&rft.date=2012-01-01&rft.volume=35&rft.issue=1&rft.spage=137&rft.epage=142&rft.pages=137-142&rft.issn=0149-5992&rft.eissn=1935-5548&rft.coden=DICAD2&rft_id=info:doi/10.2337/dc11-1383&rft_dat=%3Cgale_pubme%3EA280004168%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=914945799&rft_id=info:pmid/22040841&rft_galeid=A280004168&rfr_iscdi=true |