Plasma Glucose After Stomach or Jejunum Glucose Infusion in Roux-En-Y Gastric Bypass Patients - a Possible Implication for Early Satiety Mechanism

Background: Morbidly obese patients undergoing gastric bypass surgery experience early satiety soon after the surgery; the mechanism of this effect is poorly understood. As blood glucose concentration plays a role in appetite regulation in humans, we hypothesized that after gastric bypass surgery glucose absorbed mainly in jejunum leads to a greater rise in plasma glucose that if it is ingested in stomach. Material and Methods: 24 non-diabetes morbidly obese patients (15 women, 9 men, mean age [+/- SD] 35.6 +/- 11.9 years, body weight 140.7 +/- 33.1 kg, BMI 46.8 +/- 8.3 kg/m(2)) undergoing Roux-en-Y gastric bypass surgery were given 10 ml of 40% glucose solution to the stomach before its size reduction and to the jejunum after gastro-jejunal anastomosis was formed. Results: After jejunal infusion blood glucose increased more rapidly and was similar to 30% higher than after stomach infusion. Moreover, this increase was less pronounced in more obese patients. Conclusion: In patients after Roux-en-Y gastric bypass surgery glucose absorbed in jejunum leads to greater rise in plasma glucose concentration than if it is ingested in stomach. This phenomenon may help explain satiety feeling occurring early in gastric bypass surgery patients.