期刊
DIABETES
卷 64, 期 9, 页码 3104-3110出版社
AMER DIABETES ASSOC
DOI: 10.2337/db14-1870
关键词
-
资金
- Covidien, Mansfield, MA
- National Center for Advancing Translational Sciences, National Institutes of Health (NIH) [UL1-TR000040, UL1-RR024156]
- NIH [DK-072011]
- Columbia University Department of Medicine
- Endocrine Fellows Foundation
- [T32-DK-007271-33S1 Sup]
Improvement in type 2 diabetes after Roux-en-Y gastric bypass (RYGB) has been attributed partly to weight loss, but mechanisms beyond weight loss remain unclear. We performed an ancillary study to the Diabetes Surgery Study to assess changes in incretins, insulin sensitivity, and secretion 1 year after randomization to lifestyle modification and intensive medical management (LS/IMM) alone (n = 34) or in conjunction with RYGB (n = 34). The RYGB group lost more weight and had greater improvement in HbA(1c). Fasting glucose was lower after RYGB than after LS/IMM, although the glucose area under the curve decreased comparably for both groups. Insulin sensitivity increased in both groups. Insulin secretion was unchanged after LS/IMM but decreased after RYGB, except for a rapid increase during the first 30 min after meal ingestion. Glucagon-like peptide 1 (GLP-1) was substantially increased after RYGB, while gastric inhibitory polypeptide and glucagon decreased. Lower HbA(1c) was most strongly correlated with the percentage of weight loss for both groups. At baseline, a greater C-peptide index and 90-min postprandial C-peptide level were predictive of lower HbAic at 1 year after RYGB. beta-Cell glucose sensitivity, which improved only after RYGB, and improved disposition index were associated with lower HbAi in both groups, independent of weight loss. Weight loss and preserved beta-cell function both predominantly determine the greatest glycemic benefit after RYGB.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据