title: Common Channel Length in Bypass Surgery Does Not Impact T2DM in Diabetic Zucker Rats.
abstract: Metabolic surgery is known to impact glucose tolerance but the exact mechanism is still unclear. Based on recently-published data, especially the role of the hindgut may require redefinition.
  
  
  
  Either a loop duodeno-jejunostomy (DJOS) with exclusion of one third of total intestinal length, a loop duodeno-ileostomy (DiOS, exclusion of two thirds), or SHAM operation was performed in 9-week-old Zucker diabetic fatty rats. One, 3, and 6 months after surgery, an oral glucose tolerance test (OGTT) and glucose-stimulated hormone analyses were conducted. Body weight was documented weekly.
  
  
  
  DJOS and DiOS animals showed significantly better glucose control in all OGTTs than the SHAM group (two-way ANOVA p < 0.0001). Body weight developed largely parallel in both intervention groups; SHAM animals had gained significantly less weight after 6 months (Mann-Whitney DJOS/DiOS vs. SHAM p < 0.05, DJOS vs. DiOS p > 0.05). Operative interventions had no impact on GLP-1 and GIP levels at any time point (Mann-Whitney p > 0.05 for all). DJOS/DiOS operations could preserve insulin production up to 6 months, while there was already a sharp decline of insulin levels in the SHAM group (Mann-Whitney: DJOS/DiOS vs. SHAM p < 0.05 for all time points). Additionally, insulin sensitivity was improved significantly 1 month postoperative in both intervention groups compared to SHAM (Mann-Whitney DJOS/DiOS vs. SHAM p < 0.05).
  
  
  
  The data of the current study demonstrate a sharp amelioration of glucose control after duodenal exclusion with unchanged levels of GLP-1 and GIP. Direct or delayed hindgut stimulation had no impact on glucose control in our model.
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106, Freiburg, Germany. Claudia.laessle@uniklinik-freiburg.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Laessle
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106, Freiburg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Michelmichel
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106, Freiburg, Germany.
authors.forename: Goran
authors.initials: G
authors.lastname: Marjanovic
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106, Freiburg, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Kuesters
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106, Freiburg, Germany.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Seifert
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106, Freiburg, Germany.
authors.forename: Ulrich T
authors.initials: UT
authors.lastname: Hopt
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106, Freiburg, Germany.
authors.forename: Jodok Matthias
authors.initials: JM
authors.lastname: Fink
mesh_terms: D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000150:complications / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D004386:Duodenum / Q000601:surgery; D004766:Enterostomy / Q000009:adverse effects / Q000379:methods; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D005951:Glucose Tolerance Test; D007333:Insulin Resistance; D007422:Intestines / Q000473:pathology* / Q000601:surgery*; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology / Q000601:surgery*; D009929:Organ Size / Q000502:physiology; D051381:Rats; D011924:Rats, Zucker
keywords: Duodeno-enterostomy; Metabolic surgery; Obesity surgery; Type 2 diabetes mellitus