title: Plasma insulin and glucose time courses after biliary pancreatic diversion in morbidly obese patients with and without diabetes.
abstract: BACKGROUND
  The exact mechanism for the dramatic effect of surgical procedures for obesity on type 2 diabetes remains unknown.
  
  
  METHODS
  Five diabetic morbidly obese patients and 5 nondiabetic morbidly obese patients undergoing biliopancreatic diversion were compared retrospectively. A 75-g trans-gastrostomy glucose tolerance test was administered on the fifth day postoperatively and a standard 75-g oral glucose tolerance test was performed on the seventh day postoperatively, with blood sampling for measuring plasma glucose and insulin levels at 0, 30, 60, 90, 120, and 180 minutes.
  
  
  RESULTS
  All 5 diabetic patients were shown, at the same time, still to have diabetes or an impaired glucose tolerance test when tested through the biliopancreatic limb but patients were normal when tested through the new alimentary channel. No significant difference was seen in the nondiabetic patients.
  
  
  CONCLUSIONS
  Biliopancreatic diversion can completely normalize the glycemic cycle in type 2 diabetes patients in the week after the intervention, even before any significant weight loss has occurred. The surgical procedure itself, designed to exclude most of the stomach, duodenum, and part of the jejunum, directly affects carbohydrate homeostasis.
authors.affiliation: Department of Human Pathology, University of Messina, Via C. Valeria, 98100 Messina, Italy. currog@unime.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Currò
authors.forename: Tommaso
authors.initials: T
authors.lastname: Centorrino
authors.forename: Vanessa
authors.initials: V
authors.lastname: Low
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Navarra
mesh_terms: D015904:Biliopancreatic Diversion; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005774:Gastrostomy; D005947:Glucose / Q000008:administration & dosage / Q000493:pharmacokinetics; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D007328:Insulin / Q000097:blood*; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D011182:Postoperative Care; D012189:Retrospective Studies; D013549:Sweetening Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin; D013549:Sweetening Agents; D005947:Glucose