title: Ileal Interposition in Rats with Experimental Type 2 Like Diabetes Improves Glycemic Control Independently of Glucose Absorption.
abstract: Bariatric operations in obese patients with type 2 diabetes often improve diabetes before weight loss is observed. In patients mainly Roux-en-Y-gastric bypass with partial stomach resection is performed. Duodenojejunal bypass (DJB) and ileal interposition (IIP) are employed in animal experiments. Due to increased glucose exposition of L-cells located in distal ileum, all bariatric surgery procedures lead to higher secretion of antidiabetic glucagon like peptide-1 (GLP-1) after glucose gavage. After DJB also downregulation of Na(+)-d-glucose cotransporter SGLT1 was observed. This suggested a direct contribution of decreased glucose absorption to the antidiabetic effect of bariatric surgery. To investigate whether glucose absorption is also decreased after IIP, we induced diabetes with decreased glucose tolerance and insulin sensitivity in male rats and investigated effects of IIP on diabetes and SGLT1. After IIP, we observed weight-independent improvement of glucose tolerance, increased insulin sensitivity, and increased plasma GLP-1 after glucose gavage. The interposed ileum was increased in diameter and showed increased length of villi, hyperplasia of the epithelial layer, and increased number of L-cells. The amount of SGLT1-mediated glucose uptake in interposed ileum was increased 2-fold reaching the same level as in jejunum. Thus, improvement of glycemic control by bariatric surgery does not require decreased glucose absorption.
authors.affiliation: Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
authors.forename: Christian Ferdinand
authors.initials: CF
authors.lastname: Jurowich
authors.affiliation: Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Otto
authors.affiliation: Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.
authors.forename: Prashanth Reddy
authors.initials: PR
authors.lastname: Rikkala
authors.affiliation: Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Wagner
authors.affiliation: Molecular Toxicology Unit, Institute for Medical Research & Occupational Health, Ksaverska Cesta 2, 10000 Zagreb, Croatia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Vrhovac
authors.affiliation: Molecular Toxicology Unit, Institute for Medical Research & Occupational Health, Ksaverska Cesta 2, 10000 Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Sabolić
authors.affiliation: Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
authors.forename: Christoph-Thomas
authors.initials: CT
authors.lastname: Germer
authors.affiliation: Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany ; Department of Molecular Plant Physiology and Biophysics, Julius-von-Sachs-Institute, University of Würzburg, Julius-von-Sachs-Platz 2, 97082 Würzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Koepsell
mesh_terms: D000818:Animals; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D019858:Enteroendocrine Cells / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D052216:Glucagon-Like Peptide 1 / Q000097:blood / Q000378:metabolism; D005947:Glucose / Q000378:metabolism; D006943:Hyperglycemia / Q000517:prevention & control*; D006965:Hyperplasia; D007003:Hypoglycemia / Q000517:prevention & control*; D007082:Ileum / Q000378:metabolism / Q000473:pathology / Q000601:surgery* / Q000648:ultrastructure; D007333:Insulin Resistance; D007408:Intestinal Absorption; D008297:Male; D008871:Microvilli / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D009765:Obesity / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D011917:Rats, Inbred Lew; D051269:Sodium-Glucose Transporter 1 / Q000378:metabolism; D013047:Specific Pathogen-Free Organisms
chemical_list: D001786:Blood Glucose; C495676:Slc5a1 protein, rat; D051269:Sodium-Glucose Transporter 1; D052216:Glucagon-Like Peptide 1; D005947:Glucose