title: The effect of selective gut stimulation on glucose metabolism after gastric bypass in the Zucker diabetic fatty rat model.
abstract: BACKGROUND
  Potential mechanisms underlying the antidiabetic effects of Roux-en-Y gastric bypass (RYGB) include altered nutrient exposure in the gut. The aim of this study was to evaluate the effects of selective gut stimulation on glucose metabolism in an obese diabetic rat model.
  
  
  METHODS
  Sixteen male Zucker diabetic fatty rats were randomly assigned to 1 of 2 groups: RYGB with gastrostomy tube (GT) insertion into the excluded stomach or a control group with GT insertion into the stomach. An insulin tolerance test (ITT), oral glucose tolerance test (OGTT), and mixed meal tolerance test (MMTT) were performed before and 14-28 days after surgery. A glucose tolerance test via GT (GTT-GT) and MMTT via GT were performed postoperatively.
  
  
  RESULTS
  Postoperatively, the RYGB group had significant decreases in weight and food intake. Both the ITT and OGTT tests revealed significantly improved glucose tolerance after RYGB. The GTT-GT showed a reversal of the improved glucose tolerance in the RYGB group. In response to meal stimulation, postoperatively, the RYGB group increased glucagon-like peptide 1 (GLP-1) secretion via the oral route and peptide YY secretion by both oral and GT routes.
  
  
  CONCLUSIONS
  When foregut exposure to nutrients was reversed after RYGB, the improvement in glucose metabolism was abrogated. This model can be extended to identify the role of gut in glucose homeostasis in type 2 diabetes.
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Shai
authors.initials: S
authors.lastname: Eldar
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Heneghan
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Schauer
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Metabolic Translational Research Center, Endocrine and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: John P
authors.initials: JP
authors.lastname: Kirwan
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: brethas@ccf.org.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Brethauer
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight / Q000502:physiology; D003921:Diabetes Mellitus, Experimental / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism; D004435:Eating / Q000502:physiology; D005215:Fasting / Q000378:metabolism; D015390:Gastric Bypass; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D005951:Glucose Tolerance Test; D006706:Homeostasis / Q000502:physiology; D007004:Hypoglycemic Agents / Q000494:pharmacology; D007328:Insulin / Q000494:pharmacology; D008297:Male; D019894:Peptide YY / Q000378:metabolism; D011184:Postoperative Period; D011897:Random Allocation; D011924:Rats, Zucker
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D019894:Peptide YY; D052216:Glucagon-Like Peptide 1
keywords: Gastrointestinal hormones; Insulin resistance; Obesity; Roux-en-Y gastric bypass; Type 2 diabetes