title: Using the hyperinsulinemic euglycemic clamp to assess insulin sensitivity at 3 months following Roux-en-Y gastric bypass surgery in type 2 diabetes patients with BMI <35 kg/m2in China.
abstract: BACKGROUND
  The aim of this study was to describe short-time effect of Roux-en-Y gastric bypass (RYGB) on insulin sensitivity (IS) of Chinese diabetes patients with body mass index (BMI) <35 kg/m2by hyperinsulinemic euglycemic clamp.
  
  
  METHODS
  We studied 15 type 2 diabete mellitus (T2DM) patients with BMI <35 kg/m2, who underwent laparoscopical Roux-en-Y gastric bypass (LRYGB). Hyperinsulinemic-euglycemic clamp were performed at baseline and at 3 months after LRYGB.
  
  
  RESULTS
  The glucose disposal rate (M value) increased significantly at 3 months after RYGB (from 3.36 ± 1.26 mg kg-1min-1to 6.30 ± 1.3 mg kg-1min-1, p < 0.001). The time to reach euglycemia at the hyperinsulinemic euglycemic clamp reduced remarkably from baseline to 3 months after RYGB (from 114.40 ± 6.11 min to 97.93 ± 8.57 min, p < 0.001). There was a marked reduction in value of HOMA-IR (from 4.47 ± 2.20 mg kg-1min-1to 2.10 ± 0.75 mg kg-1min-1, p < 0.001). The parameters of body fat distribution (body weight, BMI, waist circumference, waist to hip radio) changed obviously after surgery. RYGB caused a significant improvement in fasting and postprandial plasma glucose and insulin, HbAc1. Preoperative M value and the time to reach steady-state correlated with changes of M and the time to reach steady-state at 3 months after RYGB.
  
  
  CONCLUSIONS
  Peripheral and hepatic IS improved remarkably at 3 months following RYGB, as an important mechanism for early improvement in T2DM patients with low BMI. And the time to reach euglycemia at the hyperinsulinemic euglycemic clamp may be an useful index of assessing insulin sensitivity. It is more reasonal to combine the time to reach euglycemia with M value for assessing IS.
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Liyong
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Pengzhou
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Xiangwu
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Weizheng
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Lingjie
authors.initials: L
authors.lastname: Tan
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China.
authors.forename: Xulong
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, People's Republic of China. Electronic address: zly8128@126.com.
authors.forename: Shaihong
authors.initials: S
authors.lastname: Zhu
mesh_terms: D000328:Adult; D002681:China; D003924:Diabetes Mellitus, Type 2; D005260:Female; D015390:Gastric Bypass; D015309:Glucose Clamp Technique; D006801:Humans; D007333:Insulin Resistance; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*
keywords: Hyperinsulinemic euglycemic clamp; Insulin sensitivity; Roux-en-Y gastric bypass