title: Preoperative β-cell function in patients with type 2 diabetes is important for the outcome of Roux-en-Y gastric bypass surgery.
abstract: The majority of the patients with type 2 diabetes (T2DM) show remission after Roux-en-Y gastric bypass (RYGB). This is the result of increased postoperative insulin sensitivity and β-cell secretion. The aim of the present study was to elucidate the importance of the preoperative β-cell function in T2DM for the chance of remission after RYGB. Fifteen patients with and 18 without T2DM had 25 g oral (OGTT) and intravenous (IVGTT) glucose tolerance tests performed at inclusion, after a diet-induced weight loss, and 4 and 18 months after RYGB. Postoperative first phase insulin secretion rate (ISR) during the IVGTT and β-cell glucose sensitivity during the OGTT increased in T2DM. Postoperative insulin sensitivity and the disposition index (DI) markedly increased in both groups. By stratifying the T2DM into two groups according to highest (T2DMhigh ) and lowest (T2DMlow ) baseline DI, a restoration of first phase ISR and β-cell glucose sensitivity were seen only in T2DMhigh . Remission of type 2 diabetes was 71 and 38% in T2DMhigh and T2DMlow , respectively. Postoperative postprandial GLP-1 concentrations increased markedly, but did not differ between the groups. Our findings emphasize the importance of the preoperative of β-cell function for remission of diabetes after RYGB.
authors: Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.|Department of Surgery, Koege Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.
authors: Michael Taulo
authors: MT
authors: Lund
authors: Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
authors: Merethe
authors: M
authors: Hansen
authors: Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
authors: Stinna
authors: S
authors: Skaaby
authors: Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
authors: Sina
authors: S
authors: Dalby
authors: Department of Surgery, Herlev Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
authors: Mikael
authors: M
authors: Støckel
authors: Department of Surgery, Koege Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.
authors: Andrea Karen
authors: AK
authors: Floyd
authors: Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
authors: Karsten
authors: K
authors: Bech
authors: Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
authors: Jørn Wulff
authors: JW
authors: Helge
authors: The NNF Center for Basic Metabolic Research and Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
authors: Jens Juul
authors: JJ
authors: Holst
authors: Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
authors: Flemming
authors: F
authors: Dela
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000378:metabolism* / Q000502:physiology; D008297:Male; D009765:Obesity / Q000503:physiopathology* / Q000601:surgery; D057234:Preoperative Period
chemical_list: D001786:Blood Glucose; D007328:Insulin; D052216:Glucagon-Like Peptide 1