Abstract
Aims: Patients who have undergone Roux-en-Y gastric bypass surgery (GB) have exaggerated postprandial insulin secretion, which has been attributed to increased meal glucose appearance and enhanced incretin effect. Here, we sought to determine β-cell glucose sensitivity in the absence of meal stimulation and insulinotropic gut factors. Materials and methods: A total of 12 non-diabetic subjects with prior GB, and 7 matched non-surgical control subjects with normal glucose tolerance were studied. Blood glucose and insulin secretion rates were measured during a graded glucose infusion at increasing and then decreasing rates. Insulin sensitivity (SI) and glucose effectiveness (SG) were determined by the minimal model. Results: GB subjects had SI comparable to that of control subjects. GB subjects had relative hyperglycaemia during the highest dose of glucose infusion associated with significantly reduced β-cell glucose sensitivity throughout both step-up (GB: 34 ± 6, CN: 82 ± 9 pmol min−1 mM−1 L, P <.0001) and step-down (GB: 31 ± 6, CN: 74 ± 9 pmol min−1 mM−1 L, P <.0001) phases of the glucose infusion. GB subjects also had reduced SG (GB: 0.04 ± 0.00, CN: 0.07 ± 0.01 min−1, P =.004). Conclusion: In the absence of enteric stimuli, β-cell sensitivity to changes in glycaemia is blunted among individuals with GB, indicating a significant shift in a fundamental property of β-cell function several years after surgery.
Original language | English (US) |
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Pages (from-to) | 872-878 |
Number of pages | 7 |
Journal | Diabetes, Obesity and Metabolism |
Volume | 20 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2018 |
Externally published | Yes |
Keywords
- gastric bypass surgery
- glucose tolerance
- β-cell glucose sensitivity
ASJC Scopus subject areas
- Endocrinology
- Internal Medicine
- Endocrinology, Diabetes and Metabolism