title: Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect.
abstract: The superior effect of Roux-en-Y gastric bypass (RYGB) on glucose control compared with laparoscopic adjustable gastric banding (LAGB) is confounded by the greater weight loss after RYGB. We therefore examined the effect of these two surgeries on metabolic parameters matched on small and large amounts of weight loss.
  
  
  
  Severely obese individuals with type 2 diabetes were tested for glucose metabolism, β-cell function, and insulin sensitivity after oral and intravenous glucose stimuli, before and 1 year after RYGB and LAGB, and at 10% and 20% weight loss after each surgery.
  
  
  
  RYGB resulted in greater glucagon-like peptide 1 release and incretin effect, compared with LAGB, at any level of weight loss. RYGB decreased glucose levels (120 min and area under the curve for glucose) more than LAGB at 10% weight loss. However, the improvement in glucose metabolism, the rate of diabetes remission and use of diabetes medications, insulin sensitivity, and β-cell function were similar after the two types of surgery after 20% equivalent weight loss.
  
  
  
  Although RYGB retained its unique effect on incretins, the superiority of the effect of RYGB over that of LAGB on glucose metabolism, which is apparent after 10% weight loss, was attenuated after larger weight loss.
authors.affiliation: New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Marlena M
authors.initials: MM
authors.lastname: Holter
authors.affiliation: New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Dutia
authors.affiliation: New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Stano
authors.affiliation: Baltimore Veterans Affairs Medical Center, Baltimore, MD.
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Prigeon
authors.affiliation: Albert Einstein School of Medicine, Bronx, NY.
authors.forename: Peter
authors.initials: P
authors.lastname: Homel
authors.affiliation: Division of Minimally Invasive Surgery, Department of Surgery, Mount Sinai St. Luke's Hospital, New York, NY.
authors.forename: James J
authors.initials: JJ
authors.lastname: McGinty
authors.affiliation: Division of Minimally Invasive Surgery, Department of Surgery, Mount Sinai St. Luke's Hospital, New York, NY.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Belsley
authors.affiliation: New York University Langone Medical Center, New York, NY.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Ren
authors.affiliation: Wyckoff Heights Medical Center, Brooklyn, NY.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rosen
authors.affiliation: New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY bbl14@columbia.edu.
authors.forename: Blandine
authors.initials: B
authors.lastname: Laferrère
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000378:metabolism* / Q000601:surgery; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D006801:Humans; D054795:Incretins / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D013549:Sweetening Agents / Q000008:administration & dosage / Q000378:metabolism*; D015431:Weight Loss / Q000502:physiology
chemical_list: D054795:Incretins; D013549:Sweetening Agents; D052216:Glucagon-Like Peptide 1; D005947:Glucose