Journal
OBESITY
Volume 30, Issue 8, Pages 1579-1588Publisher
WILEY
DOI: 10.1002/oby.23475
Keywords
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Categories
Funding
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health [U01DK-094406, U01DK-094430, U01DK-094431, U01DK-094438, U01DK-094467, P30DK-017047, P30DK-020595, P30DK-045735, P30DK-097512, UL1TR-000430, UL1TR-001082, UL1TR-001108, UL1TR-001855, UL1TR-001857, UL1TR-001858, UL1TR-001863]
- Abbott Laboratories
- Apollo Endosurgery
- Allergan Corporation
- American Diabetes Association
- Kaiser Permanente Southern California
- Department of Veterans Affairs
- Novo Nordisk A/S
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Weight loss can improve insulin sensitivity and beta-cell function, and its contribution after surgical or medical intervention can be compared using different treatment methods. L + M treatment can enhance beta-cell function independent of weight loss, while laparoscopic gastric banding does not provide a net benefit to beta-cell function.
Objective The extent to which weight loss contributes to increases in insulin sensitivity (IS) and beta-cell function after surgical or medical intervention has not been directly compared in individuals with impaired glucose tolerance or newly diagnosed type 2 diabetes. Methods The Restoring Insulin Secretion (RISE) Study included adults in the Beta-Cell Restoration Through Fat Mitigation Study (n = 88 randomized to laparoscopic gastric banding or metformin [MET]) and the Adult Medication Study (n = 267 randomized to placebo, MET, insulin glargine/MET, or liraglutide + MET [L + M]). IS and beta-cell responses were measured at baseline and after 12 months by modeling of oral glucose tolerance tests and during arginine-stimulated hyperglycemic clamps. Linear regression models assessed differences between and within treatments over time. Results BMI decreased in all treatment groups, except placebo, at 12 months. IS increased in all arms except placebo and was inversely correlated with changes in BMI. L + M was the only treatment arm that enhanced multiple measures of beta-cell function independent of weight loss. Insulin secretion decreased in the laparoscopic gastric banding arm proportional to increases in IS, with no net benefit on beta-cell function. Conclusions Reducing demand on the beta-cell by improving IS through weight loss does not reverse beta-cell dysfunction. L + M was the only treatment that enhanced beta-cell function.
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