title: Comparison of consumption behavior and appetite sensations among patients with type 2 diabetes mellitus after bariatric surgery.
abstract: BACKGROUND
  The promising postsurgical weight loss and remission of type 2 diabetes (T2D) from bariatric surgery can be attributed to modified eating physiology after surgical procedures. We sought to investigate the changes in the parameters of consumption behaviors and appetite sensations induced by a mixed meal tolerance test, and to correlate these alterations with age, body mass index, C-peptide levels, and duration of T2D 1 year after bariatric surgery.
  
  
  METHODS
  A total of 16 obese patients with T2D who underwent mini-gastric bypass (GB) and 16 patients who underwent sleeve gastrectomy (SG) were enrolled in this study and evaluated using a mixed meal tolerance test one year after surgery. A visual analogue scale was used for scoring appetite sensation at different time points. The area under the curve (AUC) and the incremental or decremental AUC (ΔAUC) were compared between the two groups.
  
  
  RESULTS
  One year after surgery, a decreasing trend in the consumption time was observed in the GB group compared to the SG group, while the duration of T2D before surgery was negatively correlated with the post-operative consumed time in those after GB. Patients who underwent GB had significantly higher fasting scores for fullness and desire to eat, higher AUC0'-180'of scores for desire to eat, as well as more effective post-meal suppression of hunger and desire to eat compared with those undergoing SG one year after surgery. Post-operative C-peptide levels were negatively correlated with ΔAUC0'-180'for hunger and ΔAUC0'-180'for desire to eat in the GB group, while negatively correlated with ΔAUC0'-180'for fullness in the SG group.
  
  
  CONCLUSIONS
  Patients with T2D after either GB or SG exhibit distinct nutrient-induced consumption behaviors and appetite sensations post-operatively, which may account for the differential effects on weight loss and glycemic control after different surgery.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan.
authors.forename: Chun
authors.initials: C
authors.lastname: Yeh
authors.affiliation: Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Emergency and Critical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Hsien-Hao
authors.initials: HH
authors.lastname: Huang
authors.affiliation: Department of Nursing, Min-Sheng General Hospital, Taoyuan, Taiwan.|Taiwan Society for Metabolic and Bariatric Surgery, Taoyuan, Taiwan.
authors.forename: Shu-Chun
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Medical Affairs Office, Taipei City Hospital Yangming Branch, Taipei, Taiwan.
authors.forename: Tung-Fang
authors.initials: TF
authors.lastname: Chen
authors.affiliation: Taiwan Society for Metabolic and Bariatric Surgery, Taoyuan, Taiwan.|Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
authors.forename: Kong-Han
authors.initials: KH
authors.lastname: Ser
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.|Taiwan Association for the Study of Small Intestinal Diseases, Guishan, Taiwan.
authors.forename: Chih-Yen
authors.initials: CY
authors.lastname: Chen
keywords: Appetite sensation; Bariatric surgery; C-peptide; Diabetes mellitus; Gastric bypass; Mixed meal tolerance test; Sleeve gastrectomy