title: Ileal effect on blood glucose, HbA1c, and GLP-1 in Goto-Kakizaki rats.
abstract: BACKGROUND
  There have been enumerable studies on the effects of glucagon-like peptide-1 (GLP-1) on satiety and pancreatic islet function, stimulating the advocacy of surgical transposition of the ileum (rich in GLP-1-generating L-cells) higher in the gastrointestinal tract for earlier stimulation. In the Goto-Kakizaki rat with naturally occurring type 2 diabetes, we studied the influence of ileal exclusion (IE) and ileal resection (IR) on blood glucose, hemoglobin A1c (HbA1c), and GLP-1.
  
  
  METHODS
  In six control (Ctrl), 10 IE, and 10 IR rats, over 12 weeks of follow-up, we determined blood glucose, HbA1c, and GLP-1.
  
  
  RESULTS
  Two animals in the IE and IR groups did not survive to week 13. Both operated groups weighed more than the Ctrl group at baseline and at 13 weeks; thus, IE and IR did not retard weight gain (p < 0.05). All three groups were equally hyperglycemic at week 13: 255 ± 10.2 Ctrl, 262 ± 11.0 IE, 292 ± 17.8 IR (mg/dl ± SEM). The three groups had statistically identical markedly elevated HbA1c percentages at week 13: 14.7 ± 28 Ctrl, 11.7 ± 3.4 IE, 13.8 ± 3.5 IR (% ± SEM). The end-study GLP-1 values (pM ± SEM) were 5 ± 0.9 Ctrl, 33 ± 8.9 IE, and 25 ± 6.7 IR. P values for intergroup differences were IE vs. Ctrl 0.02, IR vs. Ctrl 0.02, and IE vs. IR 0.59.
  
  
  CONCLUSIONS
  Neither IE nor IR resulted in a decrease in the mean GLP-1 level. On the contrary, the exclusion or resection of the L-cell rich ileum raised GLP-1 levels 5- to 6-fold. This increase in the GLP-1 was not associated with the mitigation of hyperglycemia or elevated HbA1c levels.
authors.affiliation: Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 290, Minneapolis, MN, 55455, USA, buchw001@umn.edu.
authors.forename: Henry
authors.initials: H
authors.lastname: Buchwald
authors.forename: Hector J
authors.initials: HJ
authors.lastname: Menchaca
authors.forename: Van N
authors.initials: VN
authors.lastname: Michalek
authors.forename: Nestor T
authors.initials: NT
authors.lastname: Bertin
mesh_terms: D000713:Anastomosis, Roux-en-Y; D000818:Animals; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004195:Disease Models, Animal; D052216:Glucagon-Like Peptide 1 / Q000097:blood*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D007082:Ileum / Q000601:surgery*; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin