Increased Insulin Secretion and Glucose Effectiveness in Obese Patients with Type 2 Diabetes following Bariatric Surgery

Roberto Visentin; Katrine Brodersen; Bjørn Richelsen; Niels Møller; Chiara Dalla Man; Andreas Kristian Pedersen; Jan Abrahamsen; Jens Juul Holst; Michael Festersen Nielsen

doi:10.1155/2023/7127426

Increased Insulin Secretion and Glucose Effectiveness in Obese Patients with Type 2 Diabetes following Bariatric Surgery

Roberto Visentin, Katrine Brodersen, Bjørn Richelsen, Niels Møller, Chiara Dalla Man, Andreas Kristian Pedersen, Jan Abrahamsen, Jens Juul Holst, Michael Festersen Nielsen^*

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

1 Citation (Scopus)

Abstract

Background. β-cell dysfunction and insulin resistance are the main mechanisms causing glucose intolerance in type 2 diabetes (T2D). Bariatric surgeries, i.e., sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), are procedures both known to induce weight loss, increase insulin action, and enhance β-cell function, but hepatic insulin extraction and glucose effectiveness may also play a role. Methods. To determine the contribution of these regulators on glucose tolerance after bariatric surgery, an oral glucose tolerance test (OGTT) was performed before and 2 months after surgery in 9 RYGB and 7 SG subjects. Eight healthy subjects served as metabolic controls. Plasma glucose, insulin, C-peptide, GLP-1, and GIP were measured during each OGTT. Insulin sensitivity and secretion, glucose effectiveness, and glucose rate of appearance were determined via oral minimal models. Results. RYGB and SG resulted in similar weight reductions (13%, RYGB (p<0.01); 14%, SG (p<0.05)). Two months after surgery, insulin secretion (p<0.05) and glucose effectiveness both improved equally in the two groups (11%, RYGB (p<0.01); 8%, SG (p>0.05)), whereas insulin sensitivity remained virtually unaltered. Bariatric surgery resulted in a comparable increase in the GLP-1 response during the OGTT, whereas GIP concentrations remained unaltered. Following surgery, oral glucose intake resulted in a comparable increase in hepatic insulin extraction, the response in both RYGB and SG patients significantly exceeding the response observed in the control subjects. Conclusions. These results demonstrate that the early improvement in glucose tolerance in obese T2D after RYGB and SG surgeries is attributable mainly to increased insulin secretion and glucose effectiveness, while insulin sensitivity seems to play only a minor role. This trial is registered with NCT02713555.

Original language	English
Article number	7127426
Journal	Journal of Diabetes Research
Volume	2023
ISSN	2314-6745
DOIs	https://doi.org/10.1155/2023/7127426
Publication status	Published - 2023

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@article{4dd64a6beac0427195acfffb3942d1e3,

title = "Increased Insulin Secretion and Glucose Effectiveness in Obese Patients with Type 2 Diabetes following Bariatric Surgery",

abstract = "Background. β-cell dysfunction and insulin resistance are the main mechanisms causing glucose intolerance in type 2 diabetes (T2D). Bariatric surgeries, i.e., sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), are procedures both known to induce weight loss, increase insulin action, and enhance β-cell function, but hepatic insulin extraction and glucose effectiveness may also play a role. Methods. To determine the contribution of these regulators on glucose tolerance after bariatric surgery, an oral glucose tolerance test (OGTT) was performed before and 2 months after surgery in 9 RYGB and 7 SG subjects. Eight healthy subjects served as metabolic controls. Plasma glucose, insulin, C-peptide, GLP-1, and GIP were measured during each OGTT. Insulin sensitivity and secretion, glucose effectiveness, and glucose rate of appearance were determined via oral minimal models. Results. RYGB and SG resulted in similar weight reductions (13%, RYGB (p<0.01); 14%, SG (p<0.05)). Two months after surgery, insulin secretion (p<0.05) and glucose effectiveness both improved equally in the two groups (11%, RYGB (p<0.01); 8%, SG (p>0.05)), whereas insulin sensitivity remained virtually unaltered. Bariatric surgery resulted in a comparable increase in the GLP-1 response during the OGTT, whereas GIP concentrations remained unaltered. Following surgery, oral glucose intake resulted in a comparable increase in hepatic insulin extraction, the response in both RYGB and SG patients significantly exceeding the response observed in the control subjects. Conclusions. These results demonstrate that the early improvement in glucose tolerance in obese T2D after RYGB and SG surgeries is attributable mainly to increased insulin secretion and glucose effectiveness, while insulin sensitivity seems to play only a minor role. This trial is registered with NCT02713555.",

author = "Roberto Visentin and Katrine Brodersen and Bj{\o}rn Richelsen and Niels M{\o}ller and {Dalla Man}, Chiara and Pedersen, {Andreas Kristian} and Jan Abrahamsen and Holst, {Jens Juul} and Nielsen, {Michael Festersen}",

note = "Publisher Copyright: {\textcopyright} 2023 Roberto Visentin et al.",

year = "2023",

doi = "10.1155/2023/7127426",

language = "English",

volume = "2023",

journal = "Journal of Diabetes Research",

issn = "2314-6745",

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Increased Insulin Secretion and Glucose Effectiveness in Obese Patients with Type 2 Diabetes following Bariatric Surgery. / Visentin, Roberto; Brodersen, Katrine ; Richelsen, Bjørn et al.
In: Journal of Diabetes Research, Vol. 2023, 7127426, 2023.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Increased Insulin Secretion and Glucose Effectiveness in Obese Patients with Type 2 Diabetes following Bariatric Surgery

AU - Visentin, Roberto

AU - Brodersen, Katrine

AU - Richelsen, Bjørn

AU - Møller, Niels

AU - Dalla Man, Chiara

AU - Pedersen, Andreas Kristian

AU - Abrahamsen, Jan

AU - Holst, Jens Juul

AU - Nielsen, Michael Festersen

PY - 2023

Y1 - 2023

N2 - Background. β-cell dysfunction and insulin resistance are the main mechanisms causing glucose intolerance in type 2 diabetes (T2D). Bariatric surgeries, i.e., sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), are procedures both known to induce weight loss, increase insulin action, and enhance β-cell function, but hepatic insulin extraction and glucose effectiveness may also play a role. Methods. To determine the contribution of these regulators on glucose tolerance after bariatric surgery, an oral glucose tolerance test (OGTT) was performed before and 2 months after surgery in 9 RYGB and 7 SG subjects. Eight healthy subjects served as metabolic controls. Plasma glucose, insulin, C-peptide, GLP-1, and GIP were measured during each OGTT. Insulin sensitivity and secretion, glucose effectiveness, and glucose rate of appearance were determined via oral minimal models. Results. RYGB and SG resulted in similar weight reductions (13%, RYGB (p<0.01); 14%, SG (p<0.05)). Two months after surgery, insulin secretion (p<0.05) and glucose effectiveness both improved equally in the two groups (11%, RYGB (p<0.01); 8%, SG (p>0.05)), whereas insulin sensitivity remained virtually unaltered. Bariatric surgery resulted in a comparable increase in the GLP-1 response during the OGTT, whereas GIP concentrations remained unaltered. Following surgery, oral glucose intake resulted in a comparable increase in hepatic insulin extraction, the response in both RYGB and SG patients significantly exceeding the response observed in the control subjects. Conclusions. These results demonstrate that the early improvement in glucose tolerance in obese T2D after RYGB and SG surgeries is attributable mainly to increased insulin secretion and glucose effectiveness, while insulin sensitivity seems to play only a minor role. This trial is registered with NCT02713555.

AB - Background. β-cell dysfunction and insulin resistance are the main mechanisms causing glucose intolerance in type 2 diabetes (T2D). Bariatric surgeries, i.e., sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), are procedures both known to induce weight loss, increase insulin action, and enhance β-cell function, but hepatic insulin extraction and glucose effectiveness may also play a role. Methods. To determine the contribution of these regulators on glucose tolerance after bariatric surgery, an oral glucose tolerance test (OGTT) was performed before and 2 months after surgery in 9 RYGB and 7 SG subjects. Eight healthy subjects served as metabolic controls. Plasma glucose, insulin, C-peptide, GLP-1, and GIP were measured during each OGTT. Insulin sensitivity and secretion, glucose effectiveness, and glucose rate of appearance were determined via oral minimal models. Results. RYGB and SG resulted in similar weight reductions (13%, RYGB (p<0.01); 14%, SG (p<0.05)). Two months after surgery, insulin secretion (p<0.05) and glucose effectiveness both improved equally in the two groups (11%, RYGB (p<0.01); 8%, SG (p>0.05)), whereas insulin sensitivity remained virtually unaltered. Bariatric surgery resulted in a comparable increase in the GLP-1 response during the OGTT, whereas GIP concentrations remained unaltered. Following surgery, oral glucose intake resulted in a comparable increase in hepatic insulin extraction, the response in both RYGB and SG patients significantly exceeding the response observed in the control subjects. Conclusions. These results demonstrate that the early improvement in glucose tolerance in obese T2D after RYGB and SG surgeries is attributable mainly to increased insulin secretion and glucose effectiveness, while insulin sensitivity seems to play only a minor role. This trial is registered with NCT02713555.

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U2 - 10.1155/2023/7127426

DO - 10.1155/2023/7127426

M3 - Journal article

C2 - 38020201

AN - SCOPUS:85178216952

SN - 2314-6745

VL - 2023

JO - Journal of Diabetes Research

JF - Journal of Diabetes Research

M1 - 7127426

ER -

Increased Insulin Secretion and Glucose Effectiveness in Obese Patients with Type 2 Diabetes following Bariatric Surgery

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