Bariatric surgery reduces oxidative stress by blunting 24-h acute glucose fluctuations in type 2 diabetic obese patients.
OBJECTIVE
We evaluated the efficacy of malabsorptive bariatric surgery on daily blood glucose fluctuations and oxidative stress in type 2 diabetic obese patients.


METHODS
The 48-h continuous subcutaneous glucose monitoring was assessed in type 2 diabetic patients before and 1 month after biliopancreatic diversion (BPD) (n = 36), or after diet-induced equivalent weight loss (n = 20). The mean amplitude of glycemic excursions and oxidative stress (nitrotyrosine) were evaluated during continuous subcutaneous glucose monitoring. During a standardized meal, glucagon-like peptide (GLP)-1, glucagon, and insulin were measured.


RESULTS
Fasting and postprandial glucose decreased equally in surgical and diet groups. A marked increase in GLP-1 occurred during the interprandial period in surgical patients toward the diet group (P < 0.01). Glucagon was more suppressed during the interprandial period in surgical patients compared with the diet group (P < 0.01). Mean amplitude of glycemic excursions and nitrotyrosine levels decreased more after BPD than after diet (P < 0.01).


CONCLUSIONS
Oxidative stress reduction after biliopancreatic diversion seems to be related to the regulation of glucose fluctuations resulting from intestinal bypass.
Marfella
Raffaele
R
Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy. raffaele.marfella@unina2.it
Barbieri
Michelangela
M
Ruggiero
Roberto
R
Rizzo
Maria Rosaria
MR
Grella
Rodolfo
R
Mozzillo
Anna Licia
AL
Docimo
Ludovico
L
Paolisso
Giuseppe
G
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D050110:Bariatric Surgery; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D018450:Disease Progression; D005234:Fatty Liver / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery*; D018384:Oxidative Stress / Q000502:physiology*; D016016:Proportional Hazards Models; D015431:Weight Loss
D001786:Blood Glucose; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase