Do Incretins play a role in the remission of type 2 diabetes after gastric bypass surgery: What are the evidence?
Gastric bypass surgery (GBP), in addition to weight loss, results in dramatic remission of type 2 diabetes (T2DM). The mechanisms by which this remission occurs are unclear. Besides weight loss and caloric restriction, the changes in gut hormones that occur after GBP are increasingly gaining recognition as key players in glucose control. Incretins are gut peptides that stimulate insulin secretion postprandially; the levels of these hormones, particularly glucagon-like peptide-1, increase after GBP in response to nutrient stimulation. Whether these changes are causal to changes in glucose homeostasis remain to be determined. The purpose of this review is to assess the evidence on incretin changes and T2DM remission after GBP, and the possible mechanisms by which these changes occur. Our goals are to provide a thorough update on this field of research so that recommendations for future research and criteria for bariatric surgery can be evaluated.
Bose
Mousumi
M
New York Obesity Research Center, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, New York, NY, 10025, USA. mbose@chpnet.org.|New York Obesity Research Center, St. Luke's Roosevelt Hospital Center, 1111 Amsterdam Avenue, Room 1034, New York, NY, 10025, USA. mbose@chpnet.org.
Oliván
Blanca
B
New York Obesity Research Center, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, New York, NY, 10025, USA.
Teixeira
Julio
J
Division of Bariatric Surgery, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, New York, NY, 10025, USA.
Pi-Sunyer
F Xavier
FX
New York Obesity Research Center, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, New York, NY, 10025, USA.
Laferrère
Blandine
B
New York Obesity Research Center, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, New York, NY, 10025, USA.
D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism* / Q000601:surgery; D019317:Evidence-Based Medicine; D015390:Gastric Bypass; D005746:Gastric Emptying; D005749:Gastric Inhibitory Polypeptide / Q000378:metabolism; D054439:Ghrelin / Q000378:metabolism; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D005943:Gluconeogenesis; D005947:Glucose / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D054795:Incretins / Q000378:metabolism*; D007421:Intestine, Small / Q000378:metabolism; D020738:Leptin / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D009767:Obesity, Morbid / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D019894:Peptide YY / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D015431:Weight Loss
D054439:Ghrelin; D054795:Incretins; D020738:Leptin; D019894:Peptide YY; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1; D005947:Glucose