title: Diabetes remission following metabolic surgery: is GLP-1 the culprit?
abstract: The parallel occurrence of improved glucose tolerance and increased glucagon-like peptide 1 (GLP-1) response to meal intake following metabolic surgery (MS) demonstrated in several studies has led to the notion that GLP-1 is the culprit for the impressive rates of remission of type 2 diabetes mellitus (T2DM) following MS. In this article, we critically review current evidence supporting this view. Recent studies specifically designed to elucidate a causative role of GLP-1 in the antidiabetic effects of MS call into question GLP-1 as a key player for T2DM outcome following MS procedures such as Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese subjects. Whether GLP-1 plays a more prominent role in the remission of T2DM following MS in subjects with moderate obesity warrants further studies. Appraisal of the mechanisms involved in the amelioration of hyperglycemia following MS is a priority, as it could help in the battle against the current combined epidemics of obesity and T2DM.
authors: Obesity Unit, Endocrinology and Diabetes Department, Hospital Clínic Universitari, Villarroel 170, 08036 Barcelona, Spain. jovidal@clinic.ub.es
authors: Josep
authors: J
authors: Vidal
authors: Amanda
authors: A
authors: Jiménez
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000601:surgery*; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism*; D006801:Humans; D009765:Obesity / Q000378:metabolism / Q000601:surgery*; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D052216:Glucagon-Like Peptide 1
references: Diabetes. 2012 Sep;61(9):2349-58
references: 22721966
references: Diabetes Obes Metab. 2012 Jun;14(6):500-10
references: 22171657
references: JAMA. 2013 Jun 5;309(21):2240-9
references: 23736733
references: J Clin Endocrinol Metab. 2011 Jul;96(7):2227-35
references: 21543426
references: Gastroenterology. 2007 May;132(6):2131-57
references: 17498508
references: Am J Physiol Endocrinol Metab. 2013 Jul 1;305(1):E59-66
references: 23651846
references: Diabetes. 2013 Jul;62(7):2380-5
references: 23434938
references: J Clin Endocrinol Metab. 2006 May;91(5):1735-40
references: 16478824
references: J Clin Endocrinol Metab. 2011 Jan;96(1):229-36
references: 21047924
references: Diabetes. 2011 Sep;60(9):2308-14
references: 21868791
references: Diabetes Care. 2012 Jul;35(7):1420-8
references: 22723580
references: Surg Obes Relat Dis. 2010 May-Jun;6(3):249-53
references: 20510288
references: Ann Surg. 2007 Nov;246(5):780-5
references: 17968169
references: Ann Surg. 2010 Sep;252(3):559-66; discussion 566-7
references: 20739857
references: J Clin Endocrinol Metab. 2011 Sep;96(9):E1372-9
references: 21778221
references: Diabetes Care. 2010 Feb;33(2):375-7
references: 19918005
references: Surg Endosc. 2012 Aug;26(8):2231-9
references: 22302537
references: J Clin Endocrinol Metab. 2008 Jul;93(7):2479-85
references: 18430778
references: Ann Surg. 2010 Dec;252(6):966-71
references: 21107106
references: Diabetes Care. 2007 Jul;30(7):1709-16
references: 17416796
references: Ann Surg. 2013 Dec;258(6):976-82
references: 23160151
references: Obes Surg. 2011 Jul;21(7):902-9
references: 21347823
references: Diabetes. 2010 Jun;59(6):1330-7
references: 20215429
references: Surg Obes Relat Dis. 2011 Nov-Dec;7(6):691-6
references: 20688578
references: Curr Opin Clin Nutr Metab Care. 2008 Jul;11(4):491-9
references: 18542012
references: Diabetologia. 2012 Jul;55(7):1890-901
references: 22538359
references: Surg Obes Relat Dis. 2010 Nov-Dec;6(6):707-13
references: 20947447
references: Surg Obes Relat Dis. 2010 May-Jun;6(3):254-9
references: 20303324
references: J Surg Res. 2012 Nov;178(1):33-9
references: 22929182
references: Ann Surg. 2012 Dec;256(6):1023-9
references: 22968072
references: J Clin Endocrinol Metab. 2010 Jan;95(1):215-21
references: 19892837
references: Int J Obes (Lond). 2011 Sep;35 Suppl 3:S45-9
references: 21912388
references: Diabetes. 2013 Sep;62(9):3044-52
references: 23649520
references: Science. 2013 Jul 26;341(6144):406-10
references: 23888041
references: Diabetes Metab Syndr. 2012 Jul-Sep;6(3):125-31
references: 23158974
references: Diabetes Care. 2013 Jul;36(7):2062-9
references: 23359363
references: Physiol Behav. 2013 Sep 10;121:70-8
references: 23562866
references: Obesity (Silver Spring). 2008 Feb;16(2):298-305
references: 18239636
references: Ann Surg. 2009 Aug;250(2):234-41
references: 19638921
references: Diabetes. 2008 May;57(5):1340-8
references: 18162504
references: Nature. 2006 Dec 14;444(7121):840-6
references: 17167471
references: J Clin Endocrinol Metab. 2010 Apr;95(4):1851-5
references: 20133462
references: J Clin Invest. 2012 Dec;122(12):4667-74
references: 23187122
references: Neurogastroenterol Motil. 2013 Apr;25(4):346-e255
references: 23360316
references: N Engl J Med. 2012 Apr 26;366(17):1567-76
references: 22449319
references: Int J Obes (Lond). 2013 Nov;37(11):1452-9
references: 23419600
references: Ann Surg. 2013 May;257(5):894-9
references: 23579541
references: Obes Surg. 2012 Jul;22(7):1077-83
references: 22419108
references: J Gastrointest Surg. 2009 Oct;13(10):1762-72
references: 19488823
references: Ann Surg. 2003 Oct;238(4):467-84; discussion 84-5
references: 14530719
references: N Engl J Med. 2012 Apr 26;366(17):1577-85
references: 22449317