[Early improvement in Type 2 diabetes in obese patients following gastric bypass and bilio-pancreatic diversion: the role of the entero-insular axis].
Improvement in Type 2 diabetes is seen in 80-98% of obese diabetic patients who undergo gastric bypass or bilio-pancreatic diversion. This improvement is evident early after the operation before significant weight loss has occurred. Although numerous teams have extensively studied the physiology of this early post-bypass amelioration of type 2 diabetes, the exact mechanism of diabetes remission remains unclear. Studies have focused on changes in the entero-insular axis, which is mediated in part by the interaction of insulinotropic hormones GIP and GIP 1 on the beta islet cells of the pancreas. Other mechanisms which have been postulated focus on the adipo-insular axis; the actions of adiponectin and leptin seem to have an important role in insulin resistance but their action is weight-loss dependent. Post-operative caloric restriction may also contribute to the early resolution of type 2 diabetes observed after gastric bypass and bilio- pancreatic diversion.
Lifante
J-C
JC
Department of surgery, Division of GI and endocrine surgery, Columbia University - New York, USA. jean-christophe.lifante@chu-lyon.fr
Inabnet
W-B
WB
D054392:Adipokines / Q000502:physiology*; D052242:Adiponectin / Q000502:physiology; D000818:Animals; D015904:Biliopancreatic Diversion; D015992:Body Mass Index; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D003921:Diabetes Mellitus, Experimental; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000601:surgery*; D005500:Follow-Up Studies; D015390:Gastric Bypass; D005749:Gastric Inhibitory Polypeptide / Q000502:physiology*; D052216:Glucagon-Like Peptide 1 / Q000502:physiology*; D006801:Humans; D054795:Incretins / Q000502:physiology*; D020738:Leptin / Q000502:physiology; D008251:Macaca; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D051381:Rats; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D054392:Adipokines; D052242:Adiponectin; D054795:Incretins; D020738:Leptin; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1