title: Insulin Sensitivity and Secretion in Obese Type 2 Diabetic Women after Various Bariatric Operations.
abstract: To compare the effects of biliopancreatic diversion (BPD) and laparoscopic gastric banding (LAGB) on insulin sensitivity and secretion with the effects of laparoscopic gastric plication (P).
  
  
  
  A total of 52 obese women (age 30-66 years) suffering from type 2 diabetes mellitus (T2DM) were prospectively recruited into three study groups: 16 BPD; 16 LAGB, and 20 P. Euglycemic clamps and mixed meal tolerance tests were performed before, at 1 month and at 6 months after bariatric surgery. Beta cell function derived from the meal test parameters was evaluated using mathematical modeling.
  
  
  
  Glucose disposal per kilogram of fat free mass (a marker of peripheral insulin sensitivity) increased significantly in all groups, especially after 1 month. Basal insulin secretion decreased significantly after all three types of operations, with the most marked decrease after BPD compared with P and LAGB. Total insulin secretion decreased significantly only following the BPD. Beta cell glucose sensitivity did not change significantly post-surgery in any of the study groups.
  
  
  
  We documented similar improvement in insulin sensitivity in obese T2DM women after all three study operations during the 6-month postoperative follow-up. Notably, only BPD led to decreased demand on beta cells (decreased integrated insulin secretion), but without increasing the beta cell glucose sensitivity.
authors.affiliation: Institute of Endocrinology, Clinical Department, Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Vrbikova
authors.forename: Marie
authors.initials: M
authors.lastname: Kunesova
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kyrou
authors.forename: Andrea
authors.initials: A
authors.lastname: Tura
authors.forename: Martin
authors.initials: M
authors.lastname: Hill
authors.forename: Tereza
authors.initials: T
authors.lastname: Grimmichova
authors.forename: Katerina
authors.initials: K
authors.lastname: Dvorakova
authors.forename: Petra
authors.initials: P
authors.lastname: Sramkova
authors.forename: Karin
authors.initials: K
authors.lastname: Dolezalova
authors.forename: Olga
authors.initials: O
authors.lastname: Lischkova
authors.forename: Josef
authors.initials: J
authors.lastname: Vcelak
authors.forename: Vojtech
authors.initials: V
authors.lastname: Hainer
authors.forename: Bela
authors.initials: B
authors.lastname: Bendlova
authors.forename: Sudhesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Martin
authors.initials: M
authors.lastname: Fried
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods*; D015904:Biliopancreatic Diversion / Q000379:methods*; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000502:physiology; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin